Individual provider Active NPI

Mary E White, LISW

  • Clinical Social Worker
  • Lakewood, OH
National Provider Identifier
1649643354
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I1302759 Issued in OH
Practice address
1505 Westwood Ave
Lakewood, OH 44107-3703
Phone
(330) 853-3875
NPI assigned
Nov 3, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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 I1302759 OH Primary

Addresses

Primary practice location

1505 Westwood Ave
Lakewood, OH 44107-3703

Mailing address

1505 Westwood Ave
Lakewood, OH 44107-3703
Phone (330) 853-3875

Other identifiers 1

IdentifierTypeStateIssuer
I1302759OtherOHSOCIAL WORK LISCENSE

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
I20160628002713 OH Practitioner - Clinical Social Worker 7810288438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Metrohealth SystemGroup PAC ID 8628982949, 1,150 clinicians

Practice addresses (Care Compare)

4229 Pearl Rd
Cleveland, OH 44109-4218
Phone (216) 957-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Feb 1, 2019 Accepting new patients
The Metrohealth System CurrentSince Feb 1, 2019 Accepting new patients

Locations

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

3950 Chester Ave
Cleveland, OH 44114
Phone (216) 431-4131

4229 Pearl Rd
Cleveland, OH 44109
Phone (216) 459-6300

4269 Pearl Rd
Cleveland, OH 44109
Phone (216) 431-4131

Organizations & group practices 2

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": "1446508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1649643354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 WESTWOOD AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073703",
            "telephone_number": "330-853-3875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WESTWOOD AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441073703",
            "telephone_number": "330-853-3875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-03",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I1302759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOCIAL WORK LISCENSE",
            "identifier": "I1302759",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

Verify at the official NPI Registry.