Individual provider Active NPI

Virginia I Clagg, LISW-S, LICDC, MBA

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1669911749
Registry record updated Jul 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1801309-SUPV Issued in OH
Practice address
31 Sherman Ave
Columbus, OH 43205-1421
Phone
(614) 352-6807
NPI assigned
Feb 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.161834 OH
Clinical Social Worker 1041C0700X I.1801309-SUPV OH Primary

Addresses

Primary practice location

31 Sherman Ave
Columbus, OH 43205-1421

Mailing address

31 Sherman Ave
Columbus, OH 43205-1421
Phone (614) 352-6807

Other practice location 1

1397 Worthington Centre Dr
Columbus, OH 43085-4901
Phone (614) 352-6807

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
I20240925004387 OH Practitioner - Clinical Social Worker 7719428010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

31 Sherman Ave
Columbus, OH 43205-1421
Phone (614) 352-6807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
LICDC.161834OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery4Life Clinical CurrentSince Jun 1, 2024 Accepting new patients

Locations

1313 E Broad St
Ste 17
Columbus, OH 43205
Phone (361) 208-4677

1397 Worthington Centre Dr
Worthington, OH 43085
Phone (614) 352-6807

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": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720828800000",
    "number": "1669911749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SHERMAN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051421",
            "telephone_number": "614-352-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SHERMAN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432051421",
            "telephone_number": "614-352-6807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1397 Worthington Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "430854901",
            "country_code": "US",
            "telephone_number": "614-352-6807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLAGG",
        "first_name": "VIRGINIA",
        "middle_name": "I",
        "credential": "LISW-S, LICDC, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161834",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1801309-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.