Individual provider Active NPI

Faith M Briscoe

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1922356203
Registry record updated Jun 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1101400 Issued in OH
Practice address
399 E Main St
Columbus, OH 43215-5384
Phone
(614) 355-8550
Fax
(614) 355-8593
NPI assigned
Aug 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2013

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.1101400 OH Primary

Addresses

Primary practice location

399 E Main St
Columbus, OH 43215-5384

Mailing address

PO Box 715194
Columbus, OH 43271-5194
Phone (614) 355-8004

Other identifiers 1

IdentifierTypeStateIssuer
2846675MedicaidOH

Other names 1

  • Faith M Blough Former name

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
I20240930001377 OH Practitioner - Clinical Social Worker 2961933114 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Adolescent Behavioral Health CurrentSince Aug 5, 2024 Accepting new patients
Child and Adolescent Behavioral Health PastSince Aug 5, 2024 Accepting new patients

Locations

405 S Linden Ave
Alliance, OH 44601
Phone (330) 433-6075

919 2nd St NE
Canton, OH 44704
Phone (330) 454-7917

1801 Schneider St NE
Canton, OH 44721
Phone (330) 454-7917

4641 Fulton Dr NW
Canton, OH 44718
Phone (330) 433-6075

Organizations & group practices 2

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": "1345161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372291200000",
    "number": "1922356203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 715194",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432715194",
            "telephone_number": "614-355-8004",
            "fax_number": "614-355-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155384",
            "telephone_number": "614-355-8550",
            "fax_number": "614-355-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISCOE",
        "first_name": "FAITH",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-17",
        "last_updated": "2013-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1101400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FAITH",
            "last_name": "BLOUGH",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.