Individual provider Active NPI

Cassaddie Roach, LSW

  • Clinical Social Worker
  • Columbus, OH
National Provider Identifier
1972094530
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.2203393 Issued in OH
Practice address
527 S High St
Columbus, OH 43215-5602
Phone
(614) 487-8758
NPI assigned
May 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 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 I.2203393 OH Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

527 S High St
Columbus, OH 43215-5602

Mailing address

527 S High St
Columbus, OH 43215-5602
Phone (614) 487-8758

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
I20220815003407 OH Practitioner - Clinical Social Worker 9537542162 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
National Youth Advocate Program, Inc Community/Behavioral Health CurrentSince Aug 2, 2022 Accepting new patients
National Youth Advocate Program, Inc Community/Behavioral Health CurrentSince Aug 2, 2022 Accepting new patients

Locations

527 S High St
Columbus, OH 43215
Phone (614) 227-9444

1801 Watermark Dr
Ste 200
Columbus, OH 43215

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1972094530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 S HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155602",
            "telephone_number": "614-487-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 S HIGH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155602",
            "telephone_number": "614-487-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "CASSADDIE",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-19",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2203393",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.