Active NPI
Craig Fischer, CDCA
- Social Worker
- Middleburg Heights, OH
National Provider Identifier
1700317849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2005350
- Practice address
- 17535 Rosbough Blvd Ste 202
Middleburg Heights, OH 44130-8362 - Phone
- (440) 223-9962
- Fax
- (440) 223-8162
- NPI assigned
- Mar 21, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.161065 | OH | |
| Social Worker | 104100000X | S.2005350 | OH | Primary |
Addresses
Primary practice location
17535 Rosbough Blvd Ste 202
Middleburg Heights, OH 44130-8362
Mailing address
17535 Rosbough Blvd Ste 202
Middleburg Heights, OH 44130-8362
Phone (440) 223-9962
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CDCA.161065 | Other | OH | CDCA LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CDCA.161065 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| S.2005350 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revolution Wellness Center LLC | Current | Accepting new patients |
Locations
17535 Rosbough Blvd
Ste 202
Middleburg Heights, OH 44130
Phone (216) 772-3310
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.
-
- Mental Health Counselor
- Middleburg Heights, OH
- NPI 1013611490
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": "1708041600000",
"number": "1700317849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17535 ROSBOUGH BLVD STE 202",
"city": "MIDDLEBURG HEIGHTS",
"state": "OH",
"postal_code": "441308362",
"telephone_number": "440-223-9962",
"fax_number": "440-223-8162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17535 ROSBOUGH BLVD STE 202",
"city": "MIDDLEBURG HEIGHTS",
"state": "OH",
"postal_code": "441308362",
"telephone_number": "440-223-9962",
"fax_number": "440-223-8162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISCHER",
"first_name": "CRAIG",
"credential": "CDCA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-03-21",
"last_updated": "2024-02-16",
"certification_date": "2024-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.161065",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2005350",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CDCA LICENSE",
"identifier": "CDCA.161065",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Middleburg Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.