Individual provider Active NPI

Alisa Renee Collins, LSW

  • Social Worker
  • Middletown, OH
National Provider Identifier
1649783150
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S1802332 Issued in OH
Practice address
4464 S Dixie Hwy
Middletown, OH 45005
Phone
(513) 649-8008
Fax
(513) 649-8004
NPI assigned
Nov 7, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S1802332 OH Primary

Addresses

Primary practice location

4464 S Dixie Hwy
Middletown, OH 45005

Mailing address

4464 S Dixie Hwy
Middletown, OH 45005-5464
Phone (513) 649-8008

Other identifiers 4

IdentifierTypeStateIssuer
H130910OtherOHPTAN GROUP
0074861OtherOHODADAS
0074946OtherOHODMH
01-0693OtherOHCARF

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Dallas, TX 75373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S1802332OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Access Counseling Services LLC PastSince Nov 4, 2014 Accepting new patients
Access Counseling Services, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1649783150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4464 S DIXIE HWY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "450055464",
            "telephone_number": "513-649-8008",
            "fax_number": "513-649-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4464 S DIXIE HWY",
            "city": "MIDDLETOWN",
            "state": "OH",
            "postal_code": "45005",
            "telephone_number": "513-649-8008",
            "fax_number": "513-649-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "ALISA",
        "middle_name": "RENEE",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1802332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN GROUP",
            "identifier": "H130910",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODADAS",
            "identifier": "0074861",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ODMH",
            "identifier": "0074946",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARF",
            "identifier": "01-0693",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, OH

Sources for this page

Verify at the official NPI Registry.