Individual provider Active NPI

Alan J Hejduk, LISW-S

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1790027324
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0800253 SUPV Issued in OH
Practice address
12201 Euclid Ave
Cleveland, OH 44106-4310
Phone
(216) 707-3406
Fax
(216) 707-3529
NPI assigned
Mar 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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.0800253 SUPV OH Primary

Addresses

Primary practice location

12201 Euclid Ave
Cleveland, OH 44106-4310

Mailing address

12201 Euclid Ave
Cleveland, OH 44106-4310
Phone (216) 707-3406

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
I20140806001666 OH Practitioner - Clinical Social Worker 8921225400 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0800253 SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Circle Health Services Past Accepting new patients

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1790027324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064310",
            "telephone_number": "216-707-3406",
            "fax_number": "216-707-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441064310",
            "telephone_number": "216-707-3406",
            "fax_number": "216-707-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEJDUK",
        "first_name": "ALAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0800253 SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.