Your Forever Home, PLLC

Primary specialty

Environmental Modification Occupational TherapistTaxonomy code 225XE0001X

License

OT 60066956 Issued in WA

Legal business name

YOUR FOREVER HOME, PLLC

Practice address

1581 NE Ohara Hills Dr
Poulsbo, WA 98370-6952

Phone

(360) 621-3341

NPI assigned

Jan 17, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Carrie Marcello, OTD, OTR/L, CAPS

Title

Occupational Therapist, Owner

Phone

(360) 621-3341

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484611200000",
    "number": "1033655816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10855 SILVERDALE WAY NW",
            "address_2": "UNIT 3175",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837551",
            "telephone_number": "360-621-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 NE OHARA HILLS DR",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706952",
            "telephone_number": "360-621-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUR FOREVER HOME, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A",
        "authorized_official_last_name": "MARCELLO",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "360-621-3341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OTD, OTR/L, CAPS"
    },
    "taxonomies": [
        {
            "code": "225XE0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "WA",
            "license": "OT 60066956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Occupational Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.