Individual provider Active NPI

Wendy M Kacmarcik, LISW-S

  • Social Worker
  • Berea, OH
National Provider Identifier
1902918196
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I 0008894 Issued in OH
Practice address
434 Eastland Rd
Berea, OH 44017-1217
Phone
(440) 234-2006
Fax
(440) 282-3400
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I 0008894 OH Primary

Addresses

Primary practice location

434 Eastland Rd
Berea, OH 44017-1217

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 234-2006

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20160707001310 OH Practitioner - Clinical Social Worker 7113219452 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 0008894OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ohioguidestone CurrentSince Jan 7, 2019 Accepting new patients
Ohioguidestone CurrentSince Jan 7, 2019 Accepting new patients
Ohioguidestone Current Accepting new patients

Locations

434 Eastland Rd
Berea, OH 44017
Phone (440) 260-8327

202 E Bagley Rd
Berea, OH 44017
Phone (440) 260-8327

2173 N Ridge Rd E
Ste E
Lorain, OH 44055
Phone (440) 260-6100

2173 N Ridge Rd E
#G
Lorain, OH 44055

1522 E Perkins Ave
Ste A
Sandusky, OH 44870
Phone (419) 610-2308

Organizations & group practices 3

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1902918196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-234-2006",
            "fax_number": "440-282-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KACMARCIK",
        "first_name": "WENDY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I 0008894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

Verify at the official NPI Registry.