Individual provider Active NPI

Michael Nassif, LISW

  • Clinical Social Worker
  • Middleburg Heights, OH
National Provider Identifier
1811308067
Registry record updated Oct 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1502357 Issued in OH
Practice address
16600 W Sprague Rd
Middleburg Heights, OH 44130-6318
Phone
(440) 897-5142
NPI assigned
May 9, 2014
Last updated
Oct 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2015

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.1502357 OH Primary

Addresses

Primary practice location

16600 W Sprague Rd
Middleburg Heights, OH 44130-6318

Mailing address

16600 W Sprague Rd
Middleburg Heights, OH 44130-6318
Phone (440) 897-5142

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
I20151109002391 OH Practitioner - Clinical Social Worker 4789994476 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Old River Associates LLCGroup PAC ID 3971846924, 2 clinicians

Practice addresses (Care Compare)

19035 Old Detroit Rd
Suite 201
Rocky River, OH 44116-1750
Phone (440) 668-5496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1502357OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gabriel Group Counseling, LLC CurrentSince Jan 1, 2017 Accepting new patients
Allied Behavioral Health Services, Incorporated Clinical CurrentSince Oct 20, 2015 Accepting new patients
Old River Associates LLC Clinical CurrentSince Nov 1, 2018 Accepting new patients
Genesis Brain Health PastSince Jan 1, 2017 Accepting new patients
Allied Behavioral Health Services, Incorporated Past Accepting new patients

Locations

22540 Lorain Rd
Fairview Park, OH 44126
Phone (440) 734-4037

16600 W Sprague Rd
Ste 245
Middleburg Heights, OH 44130
Phone (440) 523-0370

19035 Old Detroit Rd
Ste 201
Rocky River, OH 44116
Phone (404) 323-6046

19645 Progress Dr
Strongsville, OH 44149

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, 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": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445040000000",
    "number": "1811308067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16600 W SPRAGUE RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441306318",
            "telephone_number": "440-897-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16600 W SPRAGUE RD",
            "city": "MIDDLEBURG HEIGHTS",
            "state": "OH",
            "postal_code": "441306318",
            "telephone_number": "440-897-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSIF",
        "first_name": "MICHAEL",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-09",
        "last_updated": "2015-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1502357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middleburg Heights, OH

Sources for this page

Verify at the official NPI Registry.