Individual provider Active NPI

Tana R Gadelsayed, LISW-S

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1811336365
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1600102 Issued in OH
Practice address
2101 Richmond Rd Ste 1005
Beachwood, OH 44122-1390
Phone
(216) 223-8530
NPI assigned
Jun 18, 2013
Last updated
May 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 72 084030 NY
Social Worker 104100000X S.0900942 OH
Clinical Social Worker 1041C0700X I.1600102 OH Primary

Addresses

Primary practice location

2101 Richmond Rd Ste 1005
Beachwood, OH 44122-1390

Mailing address

10622 Lake Shore Blvd
Bratenahl, OH 44108-1017
Phone (216) 223-8530

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
72 084030NYMDSocial Worker
S.0900942OHMDSocial Worker
I.1600102OHMDClinical Social Worker

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, 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": "1371513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684454400000",
    "number": "1811336365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10622 LAKE SHORE BLVD",
            "city": "BRATENAHL",
            "state": "OH",
            "postal_code": "441081017",
            "telephone_number": "216-223-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 RICHMOND RD STE 1005",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441221390",
            "telephone_number": "216-223-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADELSAYED",
        "first_name": "TANA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-18",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "72 084030",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0900942",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1600102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.