Hayley Fahrnbach, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2102828 Issued in OH

Practice address

1501 Madison Rd
Walnut Hills, OH 45206-1706

Phone

(513) 354-7100

NPI assigned

Dec 20, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Miss Hayley Cole Former name

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Leap-Lifelong Empowerment ABA and Psychotherapy LLCGroup PAC ID 3577093012, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Leap-Lifelong Empowerment ABA & Psychotherapy LLC

  • Mental Health Counselor
  • Farmington, CT
  • NPI 1740010297
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1821504366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3813 OLEARY AVE",
            "city": "DEER PARK",
            "state": "OH",
            "postal_code": "45236",
            "telephone_number": "513-376-1553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MADISON RD",
            "city": "WALNUT HILLS",
            "state": "OH",
            "postal_code": "452061706",
            "telephone_number": "513-354-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRNBACH",
        "first_name": "HAYLEY",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2021-08-03",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S.1802885",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2102828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "00000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAYLEY",
            "last_name": "COLE",
            "prefix": "MISS",
            "credential": "LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ceykalia S Evans
• Deboragh L Evans
• Whitney Evans, QMHS BA
• Austin L Eversole
• Luke Ewald
• Sierra Farley, QMHS BA
• Maryellen R Fazenbaker
• Rachael Fenton
• Skylar P Ferguson, CDCA
• Amber Ferrell

• Clinical Social Worker in Walnut Hills, OH
• Providers in Walnut Hills, 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 Aug 3, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.