Individual provider Active NPI

Tricia Annette Podkowa, LSW

  • Social Worker
  • Warren, OH
National Provider Identifier
1811481138
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S1302116 Issued in OH
Practice address
103 W Market St
Warren, OH 44481-1017
Phone
(330) 394-8831
NPI assigned
Jun 20, 2018
Last updated
Jun 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S1302116 OH Primary

Addresses

Primary practice location

103 W Market St
Warren, OH 44481-1017

Mailing address

103 West Market St
Warren, OH 44481
Phone (330) 394-8831

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
I20240605001291 OH Practitioner - Clinical Social Worker 3476095530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

103 W Market St
Warren, OH 44481-1017
Phone (330) 394-8831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S1302116OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coleman Professional Services, Inc. Social Worker CurrentSince Apr 14, 2024 Accepting new patients

Locations

5982 Rhodes Rd
Kent, OH 44240
Phone (330) 676-6875

3920 Lovers Ln
Ravenna, OH 44266
Phone (330) 676-8045

3922 Lovers Ln
Ravenna, OH 44266
Phone (330) 296-3555

103 W Market St
Warren, OH 44481
Phone (330) 392-1100

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1811481138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WEST MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "44481",
            "telephone_number": "330-394-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444811017",
            "telephone_number": "330-394-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODKOWA",
        "first_name": "TRICIA",
        "middle_name": "ANNETTE",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1302116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

Verify at the official NPI Registry.