Individual provider Active NPI

Ceirra W Myles, MSW, LISW

  • Clinical Social Worker
  • Moraine, OH
National Provider Identifier
1770087132
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2506456 Issued in OH
Practice address
3095 Kettering Blvd
Moraine, OH 45439-1983
Phone
(937) 293-8300
NPI assigned
Mar 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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 S1802643 OH
Clinical Social Worker 1041C0700X I.2506456 OH Primary

Addresses

Primary practice location

3095 Kettering Blvd
Moraine, OH 45439-1983

Mailing address

3095 Kettering Blvd
Moraine, OH 45439-1983
Phone (937) 991-4723

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
I20250605002612 OH Practitioner - Clinical Social Worker 9638689029 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S1802643OHMDSocial Worker
I.2506456OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
South Community Inc. CurrentSince May 23, 2025 Accepting new patients
South Community Inc CurrentSince May 23, 2025 Accepting new patients

Locations

3095 Kettering Blvd
Moraine, OH 45439

Organizations & group practices 2

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1770087132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-991-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 KETTERING BLVD",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391983",
            "telephone_number": "937-293-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYLES",
        "first_name": "CEIRRA",
        "middle_name": "W",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-21",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1802643",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2506456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.