Individual provider Active NPI

Abigail Pierce, LISW

  • Clinical Social Worker
  • Chardon, OH
National Provider Identifier
1679057483
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2305034 Issued in OH
Practice address
12557 Ravenwood Dr
Chardon, OH 44024-9009
Phone
(440) 285-3568
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X S.1501052 OH
Clinical Social Worker 1041C0700X I.2305034 OH Primary
Social Worker 104100000X S.1501052 OH

Addresses

Primary practice location

12557 Ravenwood Dr
Chardon, OH 44024-9009

Mailing address

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

Other names 1

  • Abigail Pahlman Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Carelogic

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
I20240828000788 OH Practitioner - Clinical Social Worker 2264971704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ravenwood Mental Health CenterGroup PAC ID 6901813922, 57 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2305034OHMDClinical Social Worker
S.1501052OHMDCommunity/Behavioral Health Agency

Practice roles

OrganizationSpecialtyStatusNew patients
Ravenwood Mental Health Center CurrentSince May 3, 2024 Accepting new patients
Ravenwood Mental Health Center Community/Behavioral Health Current Accepting new patients
Ravenwood Mental Health Center CurrentSince May 3, 2024 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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1679057483",
    "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": "PIERCE",
        "first_name": "ABIGAIL",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "S.1501052",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2305034",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1501052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Carelogic",
            "affiliation": "N",
            "address_1": "9220 Mentor Ave",
            "city": "Mentor",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440606412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "PAHLMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.