NPIMap

Individual provider Active NPI

Myta Weisberg, LISW

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1659496396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0004257 Issued in OH
Practice address
24200 Chagrin Blvd
The Office Place
Beachwood, OH 44122-5550
Phone
(216) 831-6466
Fax
(216) 766-6084
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 I0004257 OH Primary

Addresses

Primary practice location

24200 Chagrin Blvd
The Office Place
Beachwood, OH 44122-5550

Mailing address

24200 Chagrin Blvd
The Office Place
Beachwood, OH 44122-5550
Phone (216) 831-6466

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0004257OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North East Ohio Health Services Past Accepting new patients

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659496396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24200 CHAGRIN BLVD",
            "address_2": "THE OFFICE PLACE",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225550",
            "telephone_number": "216-831-6466",
            "fax_number": "216-766-6084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24200 CHAGRIN BLVD",
            "address_2": "THE OFFICE PLACE",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225550",
            "telephone_number": "216-831-6466",
            "fax_number": "216-766-6084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISBERG",
        "first_name": "MYTA",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0004257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.