NPIMap

Organization Active NPI

Oakwood Counseling Center Inc

  • Psychologist
  • Warren, OH
National Provider Identifier
1265493928
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5000 Issued in OH
Legal business name
OAKWOOD COUNSELING CENTER INC
Practice address
1704 N Rd SE
Albert M Pondillo PHD
Warren, OH 44484
Phone
(330) 856-4111
Fax
(330) 856-5839
NPI assigned
Mar 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Albert M Pondillo Jr., PHDNPI 1194733147
Title
Psychologist Owner
Phone
(330) 856-4111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5000 OH Primary

Addresses

Primary practice location

1704 N Rd SE
Albert M Pondillo PHD
Warren, OH 44484

Mailing address

1704 N Rd SE
Albert M Pondillo PHD
Warren, OH 44484
Phone (330) 856-4111

Other identifiers 1

IdentifierTypeStateIssuer
2022948MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090611000498 OH Part B Supplier - Clinic/Group Practice 4385794403 Receives reassigned benefits from 10 practitioners
Practice locations: Warren, OH

National Provider Directory

National Provider Directory

Locations

1704 North Rd SE
#M
Warren, OH 44484
Phone (330) 856-4111

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265493928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 N RD SE",
            "address_2": "ALBERT M PONDILLO PHD",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "44484",
            "telephone_number": "330-856-4111",
            "fax_number": "330-856-5839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 N RD SE",
            "address_2": "ALBERT M PONDILLO PHD",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "44484",
            "telephone_number": "330-856-4111",
            "fax_number": "330-856-5839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAKWOOD COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PONDILLO",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOLOGIST OWNER",
        "authorized_official_telephone_number": "330-856-4111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2022948",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.