Individual provider Active NPI

Victoria Elizabeth Lawrence, LISW

  • Clinical Social Worker
  • Grafton, OH
National Provider Identifier
1649592502
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 1101029 Issued in OH
Practice address
2075 Avon Belden Rd
Grafton, OH 44044-9805
Phone
(440) 748-1049
Fax
(440) 748-1179
NPI assigned
Feb 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I 1101029 OH Primary
Clinical Social Worker 1041C0700X S 0901048 OH

Addresses

Primary practice location

2075 Avon Belden Rd
Grafton, OH 44044-9805

Mailing address

2075 Avon Belden Rd
Grafton, OH 44044-9805
Phone (440) 748-1049

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
I20121117000032 OH Practitioner - Clinical Social Worker 0143471367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Lakeshore Health and WellnessGroup PAC ID 6103167333, 2 clinicians

Practice addresses (Care Compare)

5475 Liberty Ave
Vermilion, OH 44089-1383
Phone (440) 963-0402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 1101029OHMDClinical Social Worker
S 0901048OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Health and Wellness CurrentSince Nov 11, 2019 Accepting new patients

Locations

5475 Liberty Ave
Vermilion, OH 44089
Phone (440) 963-0402

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": "1266537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400716800000",
    "number": "1649592502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 AVON BELDEN RD",
            "city": "GRAFTON",
            "state": "OH",
            "postal_code": "440449805",
            "telephone_number": "440-748-1049",
            "fax_number": "440-748-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 AVON BELDEN RD",
            "city": "GRAFTON",
            "state": "OH",
            "postal_code": "440449805",
            "telephone_number": "440-748-1049",
            "fax_number": "440-748-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "VICTORIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-19",
        "last_updated": "2014-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 1101029",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S 0901048",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, OH

Sources for this page

Verify at the official NPI Registry.