Individual provider Active NPI

Heather Stone, LSW, CDCA

  • Clinical Social Worker
  • Mount Gilead, OH
National Provider Identifier
1679004709
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S.1700450 Issued in OH
Practice address
245 Neal Ave
Mount Gilead, OH 43338-9372
Phone
(419) 946-6734
Fax
(419) 946-6952
NPI assigned
Mar 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S.1700450 OH Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 130769 OH

Addresses

Primary practice location

245 Neal Ave
Mount Gilead, OH 43338-9372

Mailing address

245 Neal Ave
Mount Gilead, OH 43338-9372
Phone (419) 946-6734

Other practice location 1

680 Park Ave W
Mansfield, OH 44906-3706
Phone (419) 528-5993 ext. 108

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
I20241127002734 OH Practitioner - Clinical Social Worker 3577098557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeast IncGroup PAC ID 8426014853, 48 clinicians

Practice addresses (Care Compare)

16 W Long St
Columbus, OH 43215-2815
Phone (614) 225-0990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
130769OHMDAddiction (Substance Use Disorder) Counselor
S.1700450OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast, Inc CurrentSince Aug 29, 2024 Accepting new patients
Southeast, Inc CurrentSince Aug 29, 2024 Accepting new patients

Locations

16 W Long St
Columbus, OH 43215

Organizations & group practices 2

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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679004709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 NEAL AVE",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433389372",
            "telephone_number": "419-946-6734",
            "fax_number": "419-946-6952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 NEAL AVE",
            "city": "MOUNT GILEAD",
            "state": "OH",
            "postal_code": "433389372",
            "telephone_number": "419-946-6734",
            "fax_number": "419-946-6952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Park Ave W",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449063706",
            "country_code": "US",
            "telephone_number": "419-528-5993 x108",
            "fax_number": "567-560-5486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "HEATHER",
        "credential": "LSW, CDCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1700450",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "130769",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Gilead, OH

Sources for this page

Verify at the official NPI Registry.