Gina Licursi, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1600350 Issued in OH

Practice address

12041 Ravenna Rd
Chardon, OH 44024-7008

Phone

(440) 286-7154

Fax

(440) 286-1037

NPI assigned

Mar 24, 2017

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

Enrolled in OH, WV2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/womensafe/r4/

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  OH, WV

  Medicare reassignment NPD
• Womensafe, Inc.

  • Clinical Social Worker
  • Chardon, OH
  • NPI 1881661718
  NPD (past)

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490313600000",
    "number": "1891226411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10025 CHILLICOTHE RD",
            "city": "KIRTLAND",
            "state": "OH",
            "postal_code": "440949734",
            "telephone_number": "440-622-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12041 RAVENNA RD",
            "city": "CHARDON",
            "state": "OH",
            "postal_code": "440247008",
            "telephone_number": "440-286-7154",
            "fax_number": "440-286-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICURSI",
        "first_name": "GINA",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "1600350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Leonetti
• Christine A. Leoson, CRNA
• Rachael Maxine Lerman, PHARM.D., BCPS
• Kevin T Lesuer, PT
• Robin M Leuchtag
• Matthew Richard Lieb, P.T.
• Valerie Alyson Lightner, LSW
• Lisa Ioannidis Lindblom, LPC
• Jami Lynn Lino
• Allison Little

• Clinical Social Worker in Chardon, OH
• Providers in Chardon, 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 Mar 24, 2017; 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.