Individual provider Active NPI

Jennifer Rose-Marie Ortiz, L.I.S.W.

  • Clinical Social Worker
  • Amherst, OH
National Provider Identifier
1811239411
Registry record updated Oct 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2304397 Issued in OH
Practice address
510 N Leavitt Rd
Amherst, OH 44001-1131
Phone
(440) 299-7816
NPI assigned
Mar 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S 1302218 OH
Clinical Social Worker 1041C0700X I.2304397 OH Primary

Addresses

Primary practice location

510 N Leavitt Rd
Amherst, OH 44001-1131

Mailing address

510 N Leavitt Rd
Amherst, OH 44001-1131
Phone (440) 299-7816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S 1302218OHMDSocial Worker
I.2304397OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rest and Renew Counseling LLC Clinical Current Accepting new patients

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698537600000",
    "number": "1811239411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N LEAVITT RD",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440011131",
            "telephone_number": "440-299-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N LEAVITT RD",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440011131",
            "telephone_number": "440-299-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTIZ",
        "first_name": "JENNIFER",
        "middle_name": "ROSE-MARIE",
        "credential": "L.I.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2023-10-29",
        "certification_date": "2023-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S 1302218",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2304397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.