Individual provider Active NPI

Mary Allison Whitmyer, LISW

  • Clinical Social Worker
  • Mason, OH
National Provider Identifier
1952643660
Registry record updated Dec 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 1600228 Issued in OH
Practice address
5212A Kings Mills Rd Ste 128
Mason, OH 45040-2319
Phone
(513) 935-0419
NPI assigned
Mar 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1303594 OH
Clinical Social Worker 1041C0700X I 1600228 OH Primary

Addresses

Primary practice location

5212A Kings Mills Rd Ste 128
Mason, OH 45040-2319

Mailing address

5212A Kings Mills Rd Ste 128
Mason, OH 45040-2319
Phone (513) 935-0419

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
I20160831003083 OH Practitioner - Clinical Social Worker 4789970682 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1303594OHMDClinical Social Worker
I 1600228OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Aug 7, 2016 Accepting new patients

Locations

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

25111 Country Club Blvd
Ste 290
North Olmsted, OH 44070
Phone (440) 614-2520

Interoperability endpoints

  • Direct secure messaging: pbc.marywhitmyer@140097.advancedmd-direct.com

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671235200000",
    "number": "1952643660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5212A KINGS MILLS RD STE 128",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450402319",
            "telephone_number": "513-935-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212A KINGS MILLS RD STE 128",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450402319",
            "telephone_number": "513-935-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMYER",
        "first_name": "MARY",
        "middle_name": "ALLISON",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-20",
        "last_updated": "2022-12-17",
        "certification_date": "2022-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "1303594",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 1600228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.