Individual provider Active NPI

Melanie J Prepetit, LISW-SUPV

  • Clinical Social Worker
  • Pepper Pike, OH
National Provider Identifier
1891003588
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.0010212-SUPV Issued in OH
Practice address
3737 Lander Rd
Pepper Pike, OH 44124-5712
Phone
(216) 831-2255
Fax
(216) 378-3906
NPI assigned
Sep 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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.0010212-SUPV OH Primary

Addresses

Primary practice location

3737 Lander Rd
Pepper Pike, OH 44124-5712

Mailing address

11801 Buckeye Rd
Cleveland, OH 44120-2620
Phone (216) 831-2255

Other identifiers 1

IdentifierTypeStateIssuer
0268768MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190820002330 OH Practitioner - Clinical Social Worker 8921336686 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0010212-SUPVOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health, Inc CurrentSince Jul 15, 2019 Accepting new patients
Signature Health Inc CurrentSince Jul 15, 2019 Accepting new patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Sep 1, 2021 Accepting new patients
Signature Health, Inc. Current Accepting new patients
Beech Brook Past Accepting new patients

Locations

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

23625 Commerce Park
Ste 100
Beachwood, OH 44122
Phone (844) 439-7976

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

38882 Mentor Ave
Willoughby, OH 44094

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1891003588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 BUCKEYE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202620",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 LANDER RD",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245712",
            "telephone_number": "216-831-2255",
            "fax_number": "216-378-3906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREPETIT",
        "first_name": "MELANIE",
        "middle_name": "J",
        "credential": "LISW-SUPV",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0010212-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0268768",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pepper Pike, OH

Sources for this page

Verify at the official NPI Registry.