Angela Marie Ivancic, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0009382 Issued in OH

Practice address

24200 Chagrin Blvd.
Beachwood, OH 44122

Phone

(216) 831-6466

Fax

(216) 766-6083

NPI assigned

May 29, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Catholic Charities Corporation

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Euclid, OH
  • NPI 1972550010
  NPD

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1992142137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24200 CHAGRIN BLVD",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-831-6466",
            "fax_number": "216-766-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24200 CHAGRIN BLVD.",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-831-6466",
            "fax_number": "216-766-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANCIC",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0009382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manica Isiguzo, M.D.
• Nilofer Salima Ismail Hameed, PT
• Anita Isom, LPC
• Tetiana Iuryniuk
• Liudmyla Ivakhiv, QMHS-M
• Izzeldin Izheman
• Jack J. Lesyk, PH.D., Inc.
• Jack Rzepka, M.D., Inc.
• Shawna Jackson Young, LCDC III, LISW
• Aisha Marie Jackson, SWA

• Clinical Social Worker in Beachwood, OH
• Providers in Beachwood, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.