Individual provider Active NPI

Holly Lynn Hirsel, LISW

  • Clinical Social Worker
  • Chardon, OH
National Provider Identifier
1669424628
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0008318 Issued in OH
Practice address
12557 Ravenwood Dr
Chardon, OH 44024-9009
Phone
(440) 285-3568
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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 I-0008318 OH Primary

Addresses

Primary practice location

12557 Ravenwood Dr
Chardon, OH 44024-9009

Mailing address

12557 Ravenwood Dr
Chardon, OH 44024-9009
Phone (440) 285-3568

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
I20170130002776 OH Practitioner - Clinical Social Worker 7214219013 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-0008318OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ravenwood Mental Health Center CurrentSince Nov 4, 2025 Accepting new patients
Ravenwood Mental Health Center CurrentSince Nov 4, 2025 Accepting new patients

Locations

12557 Ravenwood Dr
Concord Twp, OH 44024
Phone (440) 990-6104

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/ravenwoodhealth/r4/

Organizations & group practices 3

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1669424628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12557 RAVENWOOD DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440249009",
            "telephone_number": "440-285-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12557 RAVENWOOD DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440249009",
            "telephone_number": "440-285-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSEL",
        "first_name": "HOLLY",
        "middle_name": "LYNN",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0008318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.