Individual provider Active NPI

Cristina Lyn Suitca, MSW, LISW

  • Clinical Social Worker
  • Alliance, OH
National Provider Identifier
1639711690
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1901842 Issued in OH
Practice address
2011 Glamorgan St Ste B
Alliance, OH 44601-2709
Phone
(330) 614-2777
NPI assigned
Oct 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.1901842 OH Primary

Addresses

Primary practice location

2011 Glamorgan St Ste B
Alliance, OH 44601-2709

Mailing address

PO Box 2688
Alliance, OH 44601-0688
Phone (330) 680-9020

Other names 1

  • Miss Cristina Lyn Hampu Former name

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
I20200529000518 OH Practitioner - Clinical Social Worker 3678994654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2011 Glamorgan St
Suite B
Alliance, OH 44601-2709
Phone (330) 680-9020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1901842OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Counseling Services LLC Clinical CurrentSince Mar 1, 2020 Accepting new patients

Locations

2011 Glamorgan St
#B
Alliance, OH 44601
Phone (304) 821-0023

Organizations & group practices 1

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": "1570752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1639711690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2688",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446010688",
            "telephone_number": "330-680-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 GLAMORGAN ST STE B",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446012709",
            "telephone_number": "330-614-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUITCA",
        "first_name": "CRISTINA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-11",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTINA",
            "last_name": "HAMPU",
            "middle_name": "LYN",
            "prefix": "MISS",
            "credential": "MSW, LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Alliance, OH

Sources for this page

Verify at the official NPI Registry.