Individual provider Active NPI

Peter Joseph Botti, LISW

  • Clinical Social Worker
  • Alliance, OH
National Provider Identifier
1023224441
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I. 0007687 Issued in OH
Practice address
1207 W State St Ste M
Alliance, OH 44601-4686
Phone
(330) 821-8407
Fax
(330) 821-8506
NPI assigned
May 15, 2007
Last updated
Jul 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LICDC.011280 OH
Clinical Social Worker 1041C0700X I. 0007687 OH Primary

Addresses

Primary practice location

1207 W State St Ste M
Alliance, OH 44601-4686

Mailing address

625 Cleveland Ave NW
Canton, OH 44702-1805
Phone (330) 455-0374

Other practice location 1

200 E State St Fl 3
Alliance, OH 44601-4936
Phone (330) 821-8503

Other identifiers 1

IdentifierTypeStateIssuer
0332237MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICDC.011280OHMDAddiction (Substance Use Disorder) Counselor
I. 0007687OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Billings Clinic CurrentSince Jan 1, 2024 Accepting new patients

Locations

4368 Dressler Rd NW
Ste 103
Canton, OH 44718
Phone (330) 433-1300

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2706/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1023224441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 W STATE ST STE M",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446014686",
            "telephone_number": "330-821-8407",
            "fax_number": "330-821-8506"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E State St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Alliance",
            "state": "OH",
            "postal_code": "446014936",
            "country_code": "US",
            "telephone_number": "330-821-8503",
            "fax_number": "330-627-0088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTTI",
        "first_name": "PETER",
        "middle_name": "JOSEPH",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.011280",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I. 0007687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0332237",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alliance, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.