Individual provider Active NPI

Sharleen Renee Ross, MSW, LSW, LCDC III

  • Addiction (Substance Use Disorder) Counselor
  • Wadsworth, OH
National Provider Identifier
1790356301
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
S.1803227 Issued in OH
Practice address
4983 Ridge Rd
Wadsworth, OH 44281-9760
Phone
(330) 621-3420
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X S.1803227 OH Primary

Addresses

Primary practice location

4983 Ridge Rd
Wadsworth, OH 44281-9760

Mailing address

4983 Ridge Rd
Wadsworth, OH 44281-9760
Phone (330) 621-3420

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
I20260617002848 OH Practitioner - Clinical Social Worker 5496227746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1077 Gorge Blvd
Akron, OH 44310-2408

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S.1803227OHMDAddiction (Substance Use Disorder) Counselor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1790356301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4983 RIDGE RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819760",
            "telephone_number": "330-621-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4983 RIDGE RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819760",
            "telephone_number": "330-621-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "SHARLEEN",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "MSW, LSW, LCDC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "S.1803227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.