Individual provider Active NPI

Renessa Banks, MA,MSW, LSW

  • Clinical Social Worker
  • Cleveland, OH
National Provider Identifier
1942847017
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1.2305031 Issued in OH
Practice address
1744 Payne Ave
Cleveland, OH 44114-2910
Phone
(216) 623-6555
NPI assigned
Dec 6, 2019
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I.2305031 OH
Clinical Social Worker 1041C0700X 1.2305031 OH Primary

Addresses

Primary practice location

1744 Payne Ave
Cleveland, OH 44114-2910

Mailing address

1764 Harding Dr
Wickliffe, OH 44092-1049
Phone (216) 258-1902

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
I20240705002247 OH Practitioner - Clinical Social Worker 5092259796 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1.2305031OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince May 2, 2025 Accepting new patients
Mental Health Services for Homeless Persons, Inc. CurrentSince May 6, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1744 Payne Ave
Cleveland, OH 44114
Phone (216) 361-8640

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

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": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1942847017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1764 HARDING DR",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440921049",
            "telephone_number": "216-258-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 PAYNE AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441142910",
            "telephone_number": "216-623-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKS",
        "first_name": "RENESSA",
        "credential": "MA,MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-06",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.2305031",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "1.2305031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.