Individual provider Active NPI

Robert Louis Lieberman, LISW-S

  • Clinical Social Worker
  • Highland Heights, OH
National Provider Identifier
1801199542
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0009955-SUPV Issued in OH
Practice address
4255 Northfield Road
Highland Heights, OH 44128-2811
Phone
(216) 292-9700
NPI assigned
Dec 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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.0009955-SUPV OH Primary

Addresses

Primary practice location

4255 Northfield Road
Highland Heights, OH 44128-2811

Mailing address

4255 Northfield Road
Highland Heights, OH 44128-2811
Phone (216) 292-9700

Other identifiers 1

IdentifierTypeStateIssuer
0199627MedicaidOH

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
I20221208002118 OH Practitioner - Clinical Social Worker 3870962194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Achievement Centers for ChildrenGroup PAC ID 2466345426, 9 clinicians

Practice addresses (Care Compare)

4255 Northfield Rd
Highland Hills, OH 44128-2811
Phone (216) 292-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0009955-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Achievement Centers for Children Clinical CurrentSince Aug 19, 2022 Accepting new patients
Achievement Centers for Children Current Accepting new patients

Locations

4255 Northfield Rd
Highland Hls, OH 44128
Phone (216) 292-9700

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1801199542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 NORTHFIELD ROAD",
            "city": "HIGHLAND HEIGHTS",
            "state": "OH",
            "postal_code": "441282811",
            "telephone_number": "216-292-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 NORTHFIELD ROAD",
            "city": "HIGHLAND HEIGHTS",
            "state": "OH",
            "postal_code": "441282811",
            "telephone_number": "216-292-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "ROBERT",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-20",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0009955-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199627",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Heights, OH

Sources for this page

Verify at the official NPI Registry.