THIRD STREET COMMUNITY CLINIC, INC (NPI# 1720407554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720407554 |
| Entity Type | Organization |
| Organization Name | THIRD STREET COMMUNITY CLINIC, INC |
| Other Organization Name | MANSFIELD FAMILY HEALTH 2 |
| Practice Address |
270 Sterkel Blvd Suite A Mansfield OH 44907-1508 |
| Mailing Address |
600 W 3rd St Mansfield OH 44906-2633 |
| Practice Telephone | 4197751141 |
| Practice Fax Number | 4195256723 |
| Mailing Telephone | 4195226191 |
| Mailing Fax Number | 4195256723 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2017-09-28 |
| Authorized Official Name | JARED POLLICK (CEO) |
| Authorized Official Telephone | 4195267880 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mansfield Family Health 2 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336411156 | Third Street Community Clinic, Inc | Clinic/Center | 741 Scholl Rd Ste A, Mansfield, OH 44907-1571 | 2012-02-09 |
| 1558576116 | Third Street Community Clinic, Inc | Clinic/Center | 770 Balgreen Dr Ste 207, Mansfield, OH 44906-4106 | 2007-05-14 |
| 1558609990 | Third Street Community Clinic, Inc | Obstetrics & Gynecology | 770 Balgreen Dr, Mansfield, OH 44906-4106 | 2013-01-18 |
| Street Address |
270 STERKEL BLVD SUITE A |
| City | MANSFIELD |
| State | OH |
| Zip Code | 44907-1508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356372593 | The Center for Individual & Family Services, Inc. | Counselor | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2006-07-05 |
| 1508466418 | Windy L Tennant | Case Manager/Care Coordinator | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2020-10-29 |
| 1275168734 | Hannah R Finley | Nurse Practitioner | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2020-03-05 |
| 1417509654 | Cassandra J Ganzhorn | Social Worker | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2019-07-09 |
| 1053972752 | Cassandra S Hetrick | Social Worker | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2019-06-24 |
| 1003373598 | Ashley M. Bierman | Behavior Technician | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2019-02-21 |
| 1740755214 | Robert D Nelson | Behavior Technician | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2018-10-10 |
| 1124593165 | Andrew W. Miller | Marriage & Family Therapist | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2018-10-05 |
| 1871072108 | Hannah L. Harwood | Case Manager/Care Coordinator | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2018-08-08 |
| 1730666538 | Connie J Morris | Case Manager/Care Coordinator | 270 Sterkel Blvd, Mansfield, OH 44907-1508 | 2018-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053932434 | Kerri Nichole Tolliver | Licensed Practical Nurse | Mansfield Comprehensive Treatment Center, 475 Lexington Ave, Mansfield, OH 44907 | 2020-04-27 |
| 1790325371 | Gabrielle Smith | Licensed Practical Nurse | 707 Scholl Rd, Mansfield, OH 44907 | 2020-01-10 |
| 1912544982 | Heidi L Mathews | Behavior Technician | 270 Sterkel Blvd., Mansfield, OH 44907 | 2019-12-09 |
| 1851942254 | Misty J Kline | Licensed Practical Nurse | 707 Scholl Rd., Mansfield, OH 44907 | 2019-09-26 |
| 1528533320 | Ohio Treatment Center, LLC | Clinic/Center | 475 Lexington Ave., Mansfield, OH 44907 | 2018-10-08 |
| 1750898722 | Hannah Rose Hardin | Behavior Technician | 1033 Larchwood R, Mansfield, OH 44907 | 2017-12-29 |
| 1932548856 | Jessica Alexis Taylor | Counselor | 641 Scholl Rd., Mansfield, OH 44907 | 2013-06-25 |
| 1336495258 | Sonal Sinha | Psychiatry & Neurology | 341 Cline Ave Ste 1, Mansfield, OH 44907 | 2012-07-29 |
| 1427321579 | Tara Kightlinger | Community Health Worker | 442 Brenda Dr, Mansfield, OH 44907 | 2012-02-21 |
| 1649557620 | William Scott Olar | Chiropractor | 1179 Lexington Ave, Mansfield, OH 44907 | 2011-11-04 |
| Find all providers in zip 44907 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336411156 | Third Street Community Clinic, Inc | Clinic/Center | 741 Scholl Rd Ste A, Mansfield, OH 44907-1571 | 2012-02-09 |
| 1912904004 | Douglas County Public Health Services Group, Inc. | Clinic/Center | 804 N Highway 5, Mansfield, MO 65704-7301 | 2005-07-05 |
| 1306499314 | Third Street Community Clinic, Inc. | Clinic/Center | 205 W Cook Rd, Mansfield, OH 44907-2405 | 2019-07-18 |
| 1972053452 | Third Street Community Clinic Inc | Clinic/Center | 200 Park Ave W, Mansfield, OH 44902-1608 | 2016-10-10 |
| 1588119598 | Third Street Community Clinic Inc | Clinic/Center | 124 N Linden Rd, Mansfield, OH 44906-2616 | 2016-08-19 |
| 1285942284 | Council for Advancement of Social Service and Education | Clinic/Center | 907 Polk St, Mansfield, LA 71052-2520 | 2010-09-24 |
| 1649599119 | Third Street Community Clinic, Inc. | Clinic/Center | 770 Balgreen Drive, Suite 207, Mansfield, OH 44906-2633 | 2010-05-24 |
| 1548594526 | Third Street Dental Mobile Van | Clinic/Center | 600 W 3rd St, Mansfield, OH 44906-2633 | 2009-09-24 |
| 1750461455 | North Penn Comprehensive Health Services | Clinic/Center | 416 S Main St, Mansfield Laurel Health Center, Mansfield, PA 16933-1510 | 2006-10-17 |
| 1336252519 | Third Street Community Clinic, Inc. | Clinic/Center | 600 W. Third Street, Mansfield, OH 44906-2633 | 2006-08-15 |
| Find all providers in MANSFIELD | ||||
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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.