Individual provider Active NPI

Mondie Gonzales, LISW

  • Clinical Social Worker
  • Strongsville, OH
National Provider Identifier
1942637665
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0009377
Practice address
17637 Shurmer Rd
Strongsville, OH 44136-6157
Phone
(216) 210-4041
NPI assigned
Sep 27, 2013
Last updated
Aug 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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 I0009377 Primary

Addresses

Primary practice location

17637 Shurmer Rd
Strongsville, OH 44136-6157

Mailing address

17637 Shurmer Rd
Strongsville, OH 44136-6157
Phone (216) 210-4041

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
I20211025003105 OH Practitioner - Clinical Social Worker 4981920642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Oasis Counseling Solutions LLCGroup PAC ID 6800284845, 3 clinicians

Practice addresses (Care Compare)

17637 Shurmer Rd
Strongsville, OH 44136-6157
Phone (216) 210-4041

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Oasis Counseling Solutions LLC Clinical CurrentSince Jul 1, 2021 Accepting new patients

Locations

13443 Detroit Ave
Ste 1
Lakewood, OH 44107

Interoperability endpoints

  • Direct secure messaging: mondiegonzales@tdh.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1942637665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17637 SHURMER RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366157",
            "telephone_number": "216-210-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17637 SHURMER RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441366157",
            "telephone_number": "216-210-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "MONDIE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "I0009377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Strongsville, OH

Sources for this page

Verify at the official NPI Registry.