Individual provider Active NPI

Lynn M Periatt, LISW

  • Clinical Social Worker
  • Blue Ash, OH
National Provider Identifier
1992224083
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1700700 Issued in OH
Practice address
10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851
Phone
(513) 984-9838
NPI assigned
Sep 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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 I.1700700 OH Primary

Addresses

Primary practice location

10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851

Mailing address

10921 Reed Hartman Hwy Ste 133
Blue Ash, OH 45242-2851

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
I20180724001786 OH Practitioner - Clinical Social Worker 8325395221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling Source IncGroup PAC ID 6709772387, 51 clinicians

Practice addresses (Care Compare)

10921 Reed Hartman Hwy
Suite 133
Blue Ash, OH 45242-2851
Phone (513) 984-9838

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.1700700OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Source Inc CurrentSince Jun 16, 2018 Accepting new patients

Locations

10921 Reed Hartman Hwy
Ste 133
Blue Ash, OH 45242
Phone (513) 984-9838

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": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1992224083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 REED HARTMAN HWY STE 133",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452422851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10921 REED HARTMAN HWY STE 133",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452422851",
            "telephone_number": "513-984-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERIATT",
        "first_name": "LYNN",
        "middle_name": "M",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ash, OH

Sources for this page

Verify at the official NPI Registry.