Individual provider Active NPI

India C Brown, LSW

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1629635941
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2002103 Issued in OH
Practice address
3500 Carnegie Ave
Cleveland, OH 44115-2641
Phone
(440) 260-8300
NPI assigned
May 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1501068 OH
Clinical Social Worker 1041C0700X I.2002103 OH Primary

Addresses

Primary practice location

3500 Carnegie Ave
Cleveland, OH 44115-2641

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 234-2006

Other practice location 1

1251 Nilles Rd Ste 5
Fairfield, OH 45014-7205
Phone (513) 939-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210928001683 OH Practitioner - Clinical Social Worker 9335546712 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1501068OHMDSocial Worker
I.2002103OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Behavioral Health LLC CurrentSince Apr 12, 2023 Accepting new patients
Washington Wellness Institute, LLC CurrentSince Sep 1, 2021 Accepting new patients
Rebirth Counseling and Therapy Services LLC CurrentSince Oct 18, 2023 Accepting new patients
Central Outreach Wellness Center Past Accepting new patients

Locations

26300 Cedar Rd
Ste 1105
Beachwood, OH 44122
Phone (216) 200-5433

780 E 185th St
Cleveland, OH 44119
Phone (216) 302-4077

16781 Chagrin Blvd
Shaker Hts, OH 44120
Phone (216) 308-9324

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1629635941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CARNEGIE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152641",
            "telephone_number": "440-260-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1251 Nilles Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "OH",
            "postal_code": "450147205",
            "country_code": "US",
            "telephone_number": "513-939-0300",
            "fax_number": "513-939-0310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "INDIA",
        "middle_name": "C",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1501068",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.