Individual provider Active NPI

Malissa Fay Boyd, LISW

  • Clinical Social Worker
  • Ontario, OH
National Provider Identifier
1750864104
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2608369 Issued in OH
Practice address
2281 Village Mall Dr Unit 2
Ontario, OH 44906-1153
Phone
(419) 951-2020
NPI assigned
Sep 12, 2018
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Private Vehicle 347C00000X
Clinical Social Worker 1041C0700X I.2608369 OH Primary
In Home Supportive Care Agency 253Z00000X
Homemaker 376J00000X
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

2281 Village Mall Dr Unit 2
Ontario, OH 44906-1153

Mailing address

2000 Noble Dr
Wooster, OH 44691-5353
Phone (330) 264-3232

Other practice location 1

668 Andover Rd
Mansfield, OH 44907-1910
Phone (419) 989-0096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Undefined Non-Physician Type (Specify)
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2267 Village Mall Dr
Unit 2
Ontario, OH 44906-1369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1802724OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Abraxas Group, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1750864104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232",
            "fax_number": "419-747-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2281 VILLAGE MALL DR UNIT 2",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061153",
            "telephone_number": "419-951-2020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "668 Andover Rd",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "OH",
            "postal_code": "449071910",
            "country_code": "US",
            "telephone_number": "419-989-0096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "MALISSA",
        "middle_name": "FAY",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-12",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2608369",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OH

Sources for this page

Verify at the official NPI Registry.