Individual provider Active NPI

Matthew Paul Zalecki, MSW, LISW

  • Clinical Social Worker
  • Maumee, OH
National Provider Identifier
1770962441
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1600183 Issued in OH
Practice address
3521 Briarfield Blvd
Maumee, OH 43537-9387
Phone
(419) 794-7259
Fax
(419) 794-7261
NPI assigned
May 27, 2015
Last updated
Oct 9, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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.1600183 OH Primary

Addresses

Primary practice location

3521 Briarfield Blvd
Maumee, OH 43537-9387

Mailing address

2200 Jefferson Ave FL 5
Toledo, OH 43604-7102

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
I20181226000973 OH Practitioner - Clinical Social Worker 7416292206 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1425 Starr Ave
Toledo, OH 43605-2456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1600183OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians-North LLC CurrentSince Oct 27, 2018 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Apr 23, 2021 Accepting new patients
Unison Behavioral Health Group, Inc. CurrentSince Jun 28, 2021 Accepting new patients
Mercy Health Physicians - North, LLC CurrentSince Oct 27, 2018 Accepting new patients
Unison Behavioral Health Group, Inc Past Accepting new patients

Locations

20 S 3rd St
Ste 210
Columbus, OH 43215
Phone (614) 208-4973

3521 Briarfield Blvd
Maumee, OH 43537
Phone (419) 794-7259

1425 Starr Ave
Toledo, OH 43605
Phone (419) 214-4673

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

544 E Woodruff Ave
Toledo, OH 43604
Phone (419) 214-4673

Organizations & group practices 5

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": "1432684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1770962441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE FL 5",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3521 BRIARFIELD BLVD",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435379387",
            "telephone_number": "419-794-7259",
            "fax_number": "419-794-7261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZALECKI",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-27",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maumee, OH

Sources for this page

Verify at the official NPI Registry.