Individual provider Active NPI

Melissa Favazza, LSW

  • Social Worker
  • Brecksville, OH
National Provider Identifier
1770857179
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S.0030953 Issued in OH
Practice address
10000 Brecksville Road
Brecksville, OH 44141
Phone
(216) 701-7630
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.0030953 OH Primary

Addresses

Primary practice location

10000 Brecksville Road
Brecksville, OH 44141

Mailing address

8261 Barbara Dr
Strongsville, OH 44136-1918
Phone (440) 570-0682

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

LicenseStateTypeSpecialty
S.0030953OHMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1770857179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8261 BARBARA DR",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441361918",
            "telephone_number": "440-570-0682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BRECKSVILLE ROAD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "44141",
            "telephone_number": "216-701-7630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVAZZA",
        "first_name": "MELISSA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0030953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brecksville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.