Individual provider Active NPI

Allison Mora

  • Clinical Social Worker
  • Lorain, OH
National Provider Identifier
1790220077
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2115 W Park Dr
Lorain, OH 44053-1138
Phone
(440) 989-4900
NPI assigned
Dec 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 Primary

Addresses

Primary practice location

2115 W Park Dr
Lorain, OH 44053-1138

Mailing address

2115 W Park Dr
Lorain, OH 44053-1138

Other identifiers 1

IdentifierTypeStateIssuer
0217925MedicaidOH

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
I20170209001008 OH Practitioner - Clinical Social Worker 8123301538 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Mar 1, 2021 Accepting new patients
Signature Health Inc CurrentSince Dec 21, 2016 Accepting new patients
Signature Health, Inc. Current Accepting new patients
Signature Health, Inc CurrentSince Dec 21, 2016 Accepting new patients

Locations

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

25101 Chagrin Blvd
Ste 200
Beachwood, OH 44122
Phone (216) 273-8127

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

38882 Mentor Ave
Willoughby, OH 44094

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1790220077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 W PARK DR",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 W PARK DR",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440531138",
            "telephone_number": "440-989-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "ALLISON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0217925",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.