Unknown Individual – Clinical Social Worker, NPI 1215200324

Clinical Social Worker

Unknown Individual is a healthcare provider. based in Aurora, Ohio. specializing in Clinical Social Worker. They hold a License No. I0004330 (OH). The NPI Number for Unknown Individual is 1215200324

Main info

Organization

Inactive

46 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1215200324

Phone

(216) 870-8888

Address

330 CHADWICK DR

Deactivation Date

21 June 2023

Doctor Profile

Medical School Name

CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY

Secondary Phone

4408460862

Graduation Year

1980 (46 years ago)

PAC ID

0042475485

Group Practice PAC ID

7911929351

Professional Enrollment ID

I20120710000115

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

330 CHADWICK DR
AURORA, OH 442026640
Phone: (216) 870-8888
Type: Mailing
199 S CHILLICOTHE RD
SUITE 208
AURORA, OH 442028830
Phone: (216) 870-8888
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44202)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 7911929351View full group profile