Active NPI
Christen Phillips
- Clinical Social Worker
- Shaker Heights, OH
National Provider Identifier
1659939635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I.2406077
- Practice address
- 22001 Fairmount Blvd
Shaker Heights, OH 44118-4819 - Phone
- (216) 932-2800
- NPI assigned
- Jun 4, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1800748-TRNE | OH | |
| Clinical Social Worker | 1041C0700X | I.2406077 | OH | Primary |
Addresses
Primary practice location
22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Mailing address
22001 Fairmount Blvd
Shaker Heights, OH 44118-4819
Other names 1
- Christen Bradford
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1800748-TRNE | OH | MD | Social Worker |
| I.2406077 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732492800000",
"number": "1659939635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22001 FAIRMOUNT BLVD",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441184819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22001 FAIRMOUNT BLVD",
"city": "SHAKER HEIGHTS",
"state": "OH",
"postal_code": "441184819",
"telephone_number": "216-932-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "CHRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-04",
"last_updated": "2024-11-25",
"certification_date": "2024-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1800748-TRNE",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I.2406077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CHRISTEN",
"last_name": "BRADFORD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Shaker Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.