Individual provider Active NPI

Charles Jay Eisinger, LPCC

  • Clinical Social Worker
  • Beachwood, OH
National Provider Identifier
1962519413
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
E3632 Issued in OH
Practice address
23250 Chagrin Blvd
Ste 425 Commerce Park Five
Beachwood, OH 44122
Phone
(216) 464-4243
Fax
(216) 595-8210
NPI assigned
Aug 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 E3632 OH Primary

Addresses

Primary practice location

23250 Chagrin Blvd
Ste 425 Commerce Park Five
Beachwood, OH 44122

Mailing address

14170 Chillicothe Rd
Novelty, OH 44072
Phone (440) 338-4691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E3632OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ellen F. Casper, PH.D. and Associates Past Accepting new patients

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, 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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962519413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14170 CHILLICOTHE RD",
            "city": "NOVELTY",
            "state": "OH",
            "postal_code": "44072",
            "telephone_number": "440-338-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23250 CHAGRIN BLVD",
            "address_2": "STE 425 COMMERCE PARK FIVE",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-464-4243",
            "fax_number": "216-595-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISINGER",
        "first_name": "CHARLES",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "E3632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.