Individual provider Active NPI

Judith Caster, MSW, LSW

  • Clinical Social Worker
  • Chardon, OH
National Provider Identifier
1790067312
Registry record updated Sep 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S0900863 Issued in OH
Practice address
12557 Ravenwood Dr
Chardon, OH 44024-9009
Phone
(440) 285-3568
NPI assigned
Sep 10, 2011
Last updated
Sep 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2011

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 S0900863 OH Primary

Addresses

Primary practice location

12557 Ravenwood Dr
Chardon, OH 44024-9009

Mailing address

45 Kenton Rd
Chagrin Falls, OH 44022-2501
Phone (440) 781-8825

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
I20190731001282 OH Practitioner - Clinical Social Worker 8729314547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Organization for Psychological Health IncGroup PAC ID 5799839023, 3 clinicians

Practice addresses (Care Compare)

34305 Solon Rd
Solon, OH 44139-2660
Phone 44034930381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S0900863OHMDClinical Social Worker

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": "1315612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315612800000",
    "number": "1790067312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 KENTON RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440222501",
            "telephone_number": "440-781-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12557 RAVENWOOD DR",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440249009",
            "telephone_number": "440-285-3568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTER",
        "first_name": "JUDITH",
        "credential": "MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-10",
        "last_updated": "2011-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S0900863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chardon, OH

Sources for this page

Verify at the official NPI Registry.