NPIMap

Individual provider Active NPI

Justin McCutcheon

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1902333701
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
S1500760 Issued in OH
Practice address
3350 Collingwood Blvd
Toledo, OH 43610-1173
Phone
(419) 255-9585
NPI assigned
May 11, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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 S1500760 OH Primary

Addresses

Primary practice location

3350 Collingwood Blvd
Toledo, OH 43610-1173

Mailing address

3350 Collingwood Blvd
Toledo, OH 43610-1173
Phone (419) 255-9585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210518003008 OH Practitioner - Clinical Social Worker 5799184016 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Toledo College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Ohio IncGroup PAC ID 7719325083, 67 clinicians

Practice addresses (Care Compare)

27062 Oakmead Dr
Perrysburg, OH 43551-2657
Phone (419) 318-5286

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S1500760OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Guided Momentum Therapy Services Clinical Current Accepting new patients
Optum Behavioral Care of Ohio, Inc CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc. Clinical CurrentSince Apr 1, 2024 Accepting new patients
Optum Behavioral Care of Ohio, Inc Current Accepting new patients
Optum Behavioral Care of Ohio, Inc Past Accepting new patients

Locations

4624 Sawmill Rd
Columbus, OH 43220
Phone (614) 457-4490

620 E Broad St
Ste 301
Columbus, OH 43215
Phone (614) 674-6076

27062 Oakmead Dr
Perrysburg, OH 43551
Phone (419) 318-5286

4159 N Holland Sylvania Rd
Ste 205
Toledo, OH 43623
Phone (419) 277-0091

Interoperability endpoints

  • Direct secure messaging: justin.mccutcheon.1@28621.direct.athenahealth.com

Organizations & group practices 11

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1902333701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 COLLINGWOOD BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436101173",
            "telephone_number": "419-255-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 COLLINGWOOD BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436101173",
            "telephone_number": "419-255-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUTCHEON",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S1500760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.