Melinda E Waggoner, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1000347 Issued in OH

Practice address

25550 Chagrin Blvd
Suite 200
Beachwood, OH 44122-5638

Phone

(216) 765-0500

Fax

(216) 765-0521

NPI assigned

Jul 31, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1821229352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25550 CHAGRIN BLVD",
            "address_2": "SUITE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225638",
            "telephone_number": "216-765-0500",
            "fax_number": "216-765-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25550 CHAGRIN BLVD",
            "address_2": "SUITE 200",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225638",
            "telephone_number": "216-765-0500",
            "fax_number": "216-765-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGGONER",
        "first_name": "MELINDA",
        "middle_name": "E",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1000347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Vlna, CNP
• Carl James Vondracek, M ED, PCC-S
• Vivian Vongruenigen, MD
• Neelam Vyas, PHARMD
• W Petersilge LLC
• Nicole S Wagner, PH.D.
• Richard J Waite, OT
• Samantha Waldeck, APRN, CNP
• Jennifer S Walinsky, PH.D.
• Erin Walker, CDCA

• Clinical Social Worker in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.