Douglas Paul Pannette, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0008711 Issued in OH

Practice address

8000 Town Centre Dr
Suite 300
Broadview Heights, OH 44147-4030

Phone

(440) 627-6962

Fax

(440) 627-6963

NPI assigned

Dec 7, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Diane Eden, MD & Associates, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Willoughby Hills, OH
  • NPI 1760449813
  NPD (past)
• Psychological & Behavioral Consultants, LLC

  dba LifeStance Health

  • Psychiatry Physician
  • Beachwood, OH
  • NPI 1811915713

  Clinical

  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1275518896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10020 LYNN DR",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441331424",
            "telephone_number": "216-406-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 TOWN CENTRE DR",
            "address_2": "SUITE 300",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441474030",
            "telephone_number": "440-627-6962",
            "fax_number": "440-627-6963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNETTE",
        "first_name": "DOUGLAS",
        "middle_name": "PAUL",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0008711",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801059153",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "515293",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN MIS",
            "identifier": "094872000",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nutrition Works, LLC
• Lucy Kathleen O'Brien, D.O.
• Ashley Osterman, FNP-BC
• Monah Pannell
• Pannette Behavioral Health Care LLC
• Adrianne Marie Parker, PMHNP-BC
• Donald G Patacca, DDS
• John Bruce Pate
• Paul Bures DO
• Annette L. Pedersen, RDN, LD, CDE

• Clinical Social Worker in Broadview Heights, OH
• Providers in Broadview Heights, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.