Individual provider Active NPI

Nicole Leigh Griffith, LISW

  • Clinical Social Worker
  • Wooster, OH
National Provider Identifier
1730628819
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2102544 Issued in OH
Practice address
2098 Portage Rd Ste 125
Wooster, OH 44691-5707
Phone
(330) 641-5696
NPI assigned
Feb 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.2102544 OH Primary

Addresses

Primary practice location

2098 Portage Rd Ste 125
Wooster, OH 44691-5707

Mailing address

2098 Portage Rd Ste 125
Wooster, OH 44691-5707
Phone (330) 641-5696

Other identifiers 1

IdentifierTypeStateIssuer
0275748MedicaidOH

Other names 1

  • Nicole Leigh Hawley Former name

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
I20210219002360 OH Practitioner - Clinical Social Worker 2668887811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Refuge CounselingGroup PAC ID 0446698898, 4 clinicians

Practice addresses (Care Compare)

1060 Claremont Ave
Suite 6
Ashland, OH 44805-3715
Phone (419) 922-9696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Village Network CurrentSince Jan 4, 2021 Accepting new patients
Refuge Counseling, LLC CurrentSince Apr 18, 2024 Accepting new patients
Mansfield Neurology Inc PastSince Apr 18, 2024 Accepting new patients

Locations

1060 Claremont Ave
Ste 6
Ashland, OH 44805
Phone (419) 526-1964

3011 Akron Rd
Wooster, OH 44691
Phone (330) 202-3875

2000 Noble Dr
Wooster, OH 44691
Phone (330) 439-8492

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": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1730628819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2098 PORTAGE RD STE 125",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915707",
            "telephone_number": "330-641-5696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2098 PORTAGE RD STE 125",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915707",
            "telephone_number": "330-641-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "NICOLE",
        "middle_name": "LEIGH",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0275748",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HAWLEY",
            "middle_name": "LEIGH",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.