DAVID V. SURNBROCK (NPI# 1760570477) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760570477 |
| Entity Type | Individual |
| Full Name | DAVID V. SURNBROCK |
| Credential | LISW |
| Practice Address |
1251 Nilles Rd Suite 5 Fairfield OH 45014-7206 |
| Practice Telephone | 5139390300 |
| Practice Fax Number | 5139390310 |
| Mailing Telephone | 5139390300 |
| Mailing Fax Number | 5139390310 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2016-03-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
I 0008354 | OH | Behavioral Health & Social Service Providers |
| Street Address |
1251 NILLES RD SUITE 5 |
| City | FAIRFIELD |
| State | OH |
| Zip Code | 45014-7206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457353484 | Mel Keith Gross | Audiologist | 1251 Nilles Rd, Ste 7, Fairfield, OH 45014-7206 | 2005-08-10 |
| 1023470580 | John A Roflow | Counselor | 1251 Nilles Rd, Suite 5, Fairfield, OH 45014-7206 | 2016-03-24 |
| 1962876003 | Gregory Wayne Pratt | Social Worker | 1251 Nilles Rd, Suite 5, Fairfield, OH 45014-7206 | 2015-11-29 |
| 1881087971 | Sarah Boettner | Counselor | 1251 Nilles Rd, Suite 5, Fairfield, OH 45014-7206 | 2015-03-12 |
| 1467864249 | Kathleen E Bosse | Counselor | 1251 Nilles Rd, Unit 5, Fairfield, OH 45014-7206 | 2014-05-28 |
| 1235554650 | Alliance Physicians, Inc. | Surgery | 1251 Nilles Rd, Suite 17, Fairfield, OH 45014-7206 | 2014-02-21 |
| 1982035200 | Sherrie Ann Kleinholz | Counselor | 1251 Nilles Rd, Suite 5, Fairfield, OH 45014-7206 | 2013-12-12 |
| 1609117761 | Rehab Advantage, L.L.C. | Physical Therapy Assistant | 1251 Nilles Rd, Unit 20, Fairfield, OH 45014-7206 | 2013-03-13 |
| 1386984524 | Kimberly S Britton | Counselor | 1251 Nilles Rd, Suite 5, Fairfield, OH 45014-7206 | 2013-02-26 |
| 1447599840 | Jacquelin M Dimenna | Counselor | 1251 Nilles Rd, Clock Tower Place, Suite 5, Fairfield, OH 45014-7206 | 2013-02-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326526872 | Megan Coleen Hamill | Registered Nurse | 6570 Sosna Drive, Fairfield, OH 45014 | 2018-08-06 |
| 1831695642 | James Grant Walther | Contractor | 16408 Jeanie Drive, Aurora, IN 45014 | 2018-04-02 |
| 1104339837 | Tamara Rochester | Registered Nurse | 5474 Yellowstone Dr, Fairfield, OH 45014 | 2017-11-16 |
| 1104335892 | Barbara Johnson | Registered Nurse | 2853 Saturn Drive, Fairfield, OH 45014 | 2017-09-25 |
| 1205373537 | Samuel E Ghee IIi | Counselor | Decoach Rehabilitation Center, 6570 Sosna Drive, Fairfield, OH 45014 | 2017-01-25 |
| 1669916789 | Lacretia Ancona | In Home Supportive Care | 700 Wessel Dr #181505, Fairfield, OH 45014 | 2016-12-08 |
| 1134676299 | Lynne Mutuku | Licensed Practical Nurse | 3975 Woodridge Blvd, Apt 10, Fairfield, OH 45014 | 2016-09-07 |
| 1104291020 | Mimi Supportive Hands .llc | Home Health | 6 Ridge Dr Apt 203, Cincinnati, OH 45014 | 2015-12-03 |
| 1215319181 | Brittany Beck | Social Worker | 3050 Mack Rd Ste 205, Fairfield, OH 45014 | 2015-06-26 |
| 1093193278 | Ashli Tanner | Specialist/Technologist | 8790 N. Gilmore Rd., Fairfield, OH 45014 | 2015-05-08 |
| Find all providers in zip 45014 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
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| 1003445008 | Jennifer Mikell Lincoln | Social Worker | 1325 Crowley Ln Apt 6, Fairfield, CA 94533-6001 | 2020-04-02 |
| 1174166185 | Holly Mundon | Social Worker | 5 Darby Heath, Fairfield, OH 45014-5261 | 2019-10-22 |
| 1831652064 | Seagull Counseling & Therapy LLC | Social Worker | 35 Nutmeg Lane, Fairfield, CT 06824 | 2019-04-14 |
| 1730642935 | Susan Lipman Henry | Social Worker | 35 Nutmeg Ln, Fairfield, CT 06824-3909 | 2019-04-13 |
| 1689138133 | Sue Nadel | Social Worker | 60 Hitching Post Ln, Fairfield, CT 06824-3133 | 2019-01-29 |
| 1194296905 | Claudia Mast | Social Worker | 301 W Burlington, Fairfield, IA 52556-5255 | 2018-12-06 |
| 1942782842 | Michael Joseph Molina | Social Worker | 510 Parker Rd, Fairfield, CA 94533-9000 | 2018-09-06 |
| 1134605256 | Ashley Marie Stringer | Social Worker | 7000 Grasselli Rd, Fairfield, AL 35064-2424 | 2018-07-11 |
| Find all providers in FAIRFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.