Individual provider Active NPI

Hannah Elizabeth Andrus, LISW

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1700495397
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2304611 Issued in OH
Practice address
4159 N Holland Sylvania Rd Ste 205
Toledo, OH 43623-4801
Phone
(419) 318-5286
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.2004905 OH
Clinical Social Worker 1041C0700X I.2304611 OH Primary

Addresses

Primary practice location

4159 N Holland Sylvania Rd Ste 205
Toledo, OH 43623-4801

Mailing address

2624 Beaufort Ave
Toledo, OH 43613-4804
Phone (419) 206-2357

Other identifiers 1

IdentifierTypeStateIssuer
0412899MedicaidOH

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
I20240409000874 OH Practitioner - Clinical Social Worker 7911345046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Ohio IncGroup PAC ID 7719325083, 67 clinicians

Practice addresses (Care Compare)

27062 Oakmead Dr
Perrysburg, OH 43551-2657
Phone (419) 318-5286

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.2004905OHMDSocial Worker
I.2304611OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Ohio, Inc CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc Current Accepting new patients
Optum Behavioral Care of Ohio, Inc. Clinical CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc Past Accepting new patients

Locations

620 E Broad St
Ste 301
Columbus, OH 43215
Phone (614) 674-6076

4624 Sawmill Rd
Columbus, OH 43220
Phone (614) 457-4490

27062 Oakmead Dr
Perrysburg, OH 43551
Phone (419) 318-5286

4159 N Holland Sylvania Rd
Ste 205
Toledo, OH 43623
Phone (419) 277-0091

Interoperability endpoints

  • Direct secure messaging: hannah.andrus.1@28621.direct.athenahealth.com

Organizations & group practices 10

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": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1700495397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 BEAUFORT AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436134804",
            "telephone_number": "419-206-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4159 N HOLLAND SYLVANIA RD STE 205",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234801",
            "telephone_number": "419-318-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRUS",
        "first_name": "HANNAH",
        "middle_name": "ELIZABETH",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2004905",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2304611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0412899",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.