Individual provider Active NPI

Charlene Ellen Crace, M.S.W., L.I.S.W.

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1942318779
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0800164 Issued in OH
Practice address
420 N James Rd
Chalmers P. Wylie VA Ambulatory Care Center
Columbus, OH 43219-1834
Phone
(614) 257-5542
Fax
(614) 257-5289
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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 0800164 OH Primary

Addresses

Primary practice location

420 N James Rd
Chalmers P. Wylie VA Ambulatory Care Center
Columbus, OH 43219-1834

Mailing address

5462 Baneberry Ave
Columbus, OH 43235-7398
Phone (614) 257-5542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, FL2 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

Enrollment IDStateProvider typePAC IDDetails
I20260528003989 OH Practitioner - Clinical Social Worker 0446720627 Reassigns benefits to 1 organization
I20260601003852 FL Practitioner - Clinical Social Worker 0446720627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0800164OHMDClinical Social Worker

Organizations & group practices 1

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1942318779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5462 BANEBERRY AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432357398",
            "telephone_number": "614-257-5542",
            "fax_number": "614-257-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "address_2": "CHALMERS P. WYLIE VA AMBULATORY CARE CENTER",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191834",
            "telephone_number": "614-257-5542",
            "fax_number": "614-257-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRACE",
        "first_name": "CHARLENE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "M.S.W., L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "0800164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.