Active NPI
Mary Jo Fornash
- Social Worker
- Grafton, OH
National Provider Identifier
1669967758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 38487 Crook St
Grafton, OH 44044-9216 - Phone
- (440) 864-8164
- NPI assigned
- Jun 29, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
38487 Crook St
Grafton, OH 44044-9216
Mailing address
38487 Crook St
Grafton, OH 44044-9216
Phone (440) 864-8164
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530230400000",
"number": "1669967758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38487 CROOK ST",
"city": "GRAFTON",
"state": "OH",
"postal_code": "440449216",
"telephone_number": "440-864-8164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38487 CROOK ST",
"city": "GRAFTON",
"state": "OH",
"postal_code": "440449216",
"telephone_number": "440-864-8164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORNASH",
"first_name": "MARY",
"middle_name": "JO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-29",
"last_updated": "2018-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grafton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.