Active NPI
Carol Jean Root, LICSW
- Clinical Social Worker
- Princeton, WV
National Provider Identifier
1184795197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- DP00452073
- Practice address
- 12 St
Princeton Community Hospital--12TH Street
Princeton, WV 24740 - Phone
- (304) 431-5073
- Fax
- (304) 487-7900
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | DP00452073 | WV | Primary |
Addresses
Primary practice location
12 St
Princeton Community Hospital--12TH Street
Princeton, WV 24740
Mailing address
12TH Street
Princeton Community Hospital
Princeton, WV 24740
Phone (304) 431-5073
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DP00452073 | WV | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184795197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12TH STREET",
"address_2": "PRINCETON COMMUNITY HOSPITAL",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740",
"telephone_number": "304-431-5073",
"fax_number": "304-487-7900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 ST",
"address_2": "PRINCETON COMMUNITY HOSPITAL--12TH STREET",
"city": "PRINCETON",
"state": "WV",
"postal_code": "24740",
"telephone_number": "304-431-5073",
"fax_number": "304-487-7900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOT",
"first_name": "CAROL",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WV",
"license": "DP00452073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.