Individual provider Active NPI

Nancy F Fitch, LISW

  • Clinical Social Worker
  • Moraine, OH
National Provider Identifier
1669586343
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0009811-SUPV Issued in OH
Practice address
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone
(937) 293-8300
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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.0009811-SUPV OH Primary

Addresses

Primary practice location

3095 Kettering Blvd
Moraine, OH 45439-1983

Mailing address

3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 293-8300

Other identifiers 1

IdentifierTypeStateIssuer
0310860MedicaidOH

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
I20061129000120 OH Practitioner - Clinical Social Worker 9436157450 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Midwest Counseling Centers of OhioGroup PAC ID 1759798366, 10 clinicians

Practice addresses (Care Compare)

8940 Kingsridge Dr
Suite 106
Dayton, OH 45458-1632
Phone (937) 813-4485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0009811-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Community Inc CurrentSince Jul 25, 2023 Accepting new patients
South Community Inc. CurrentSince Jul 25, 2023 Accepting new patients
Midwest Counseling Centers of Ohio CurrentSince Dec 18, 2023 Accepting new patients
Greenhouse and Associates Inc. Past Accepting new patients

Locations

8940 Kingsridge Dr
Ste 106
Dayton, OH 45458
Phone (937) 432-9130

3095 Kettering Blvd
Moraine, OH 45439

Organizations & group practices 4

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1669586343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-293-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-293-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "NANCY",
        "middle_name": "F",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0009811-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0310860",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.