Active NPI
Monique Estella Primm, LSW
- Social Worker
- Cleveland, OH
National Provider Identifier
1720599095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1601173
- Practice address
- 4600 Carnegie Ave
Cleveland, OH 44103-4371 - Phone
- (216) 431-3434
- NPI assigned
- Oct 13, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1601173 | OH | Primary |
Addresses
Primary practice location
4600 Carnegie Ave
Cleveland, OH 44103-4371
Mailing address
22140 Euclid Ave Apt 401
Euclid, OH 44117-1614
Phone (216) 704-9123
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S.1601173 | Medicaid | OH |
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 |
|---|---|---|---|
| S.1601173 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507852800000",
"number": "1720599095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22140 EUCLID AVE APT 401",
"city": "EUCLID",
"state": "OH",
"postal_code": "441171614",
"telephone_number": "216-704-9123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 CARNEGIE AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441034371",
"telephone_number": "216-431-3434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIMM",
"first_name": "MONIQUE",
"middle_name": "ESTELLA",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-13",
"last_updated": "2017-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1601173",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "S.1601173",
"state": "OH"
}
],
"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 Oct 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.