Organization Active NPI

Flourishing Feelings, LLC

  • Clinical Social Worker
  • Tallmadge, OH
National Provider Identifier
1982365466
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FLOURISHING FEELINGS, LLC
Practice address
125 West Ave Ste 104
Tallmadge, OH 44278-2200
Phone
(330) 714-1341
NPI assigned
Jan 6, 2022
Last updated
Jan 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Authorized official

Name
Jan Maynor, LISW-SNPI 1841368099
Title
Clinical Director
Phone
(330) 714-1341

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

125 West Ave Ste 104
Tallmadge, OH 44278-2200

Mailing address

2501 Reimer Rd
Wadsworth, OH 44281-9229
Phone (330) 714-1341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240806001184 OH Part B Supplier - Clinic/Group Practice 0648717827 Receives reassigned benefits from 1 practitioner
Practice locations: Tallmadge, OH

National Provider Directory

National Provider Directory

Locations

125 West Ave
Ste 104
Tallmadge, OH 44278
Phone (330) 714-1341

125 West Ave
Ste 104A
Tallmadge, OH 44278
Phone (330) 714-1341

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1982365466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 REIMER RD",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442819229",
            "telephone_number": "330-714-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WEST AVE STE 104",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442782200",
            "telephone_number": "330-714-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLOURISHING FEELINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "MAYNOR",
        "authorized_official_first_name": "JAN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "330-714-1341",
        "authorized_official_credential": "LISW-S"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallmadge, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.