Individual provider Active NPI

Coretta Daniel, LSW

  • Social Worker
  • Cleveland, OH
National Provider Identifier
1679289599
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.1303660 Issued in OH
Practice address
1744 Payne Ave
Cleveland, OH 44114-2910
Phone
(216) 623-6555
NPI assigned
Jan 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X S.1303660 OH
Clinical Social Worker 1041C0700X S.1303660 OH
Social Worker 104100000X S.1303660 OH Primary

Addresses

Primary practice location

1744 Payne Ave
Cleveland, OH 44114-2910

Mailing address

3643 Central Ave
Cleveland, OH 44115-3023
Phone (216) 659-7080

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

State licenses

LicenseStateTypeSpecialty
S.1303660OHMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1679289599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 CENTRAL AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441153023",
            "telephone_number": "216-659-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 PAYNE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142910",
            "telephone_number": "216-623-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "CORETTA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "S.1303660",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1303660",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1303660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.