Individual provider Active NPI

Carrie A Sellers, LISW

  • Clinical Social Worker
  • Wadsworth, OH
National Provider Identifier
1326203928
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I 0700059-S Issued in OH
Practice address
1392 High St Ste 205
Wadsworth, OH 44281-8257
Phone
(330) 227-4518
Fax
(855) 975-3166
NPI assigned
Jul 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I 0700059-S OH Primary

Addresses

Primary practice location

1392 High St Ste 205
Wadsworth, OH 44281-8257

Mailing address

1392 High St Ste 205
Wadsworth, OH 44281-8257
Phone (330) 227-4518

Other practice location 1

246 Northland Dr Ste 200A
Medina, OH 44256-1533
Phone (330) 725-9195

Other identifiers 1

IdentifierTypeStateIssuer
0369772MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230228002043 OH Practitioner - Clinical Social Worker 8224401930 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Ohio State University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psych Foundations, LLCGroup PAC ID 5597161026, 5 clinicians

Practice addresses (Care Compare)

1392 High St
Suite 205
Wadsworth, OH 44281-8257
Phone (330) 227-4518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I 0700059-SOHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Foundations, LLC CurrentSince Feb 1, 2023 Accepting new patients
Pastoral Counseling Service of Summit County PastSince Oct 1, 2019 Accepting new patients
Pastoral Counseling Service of Summit Co Inc PastSince Feb 23, 2020 Accepting new patients

Locations

1392 High St
Ste 205
Wadsworth, OH 44281
Phone (330) 227-4518

273 Main St
Ste 300
Wadsworth, OH 44281
Phone (330) 227-4518

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1326203928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1392 HIGH ST STE 205",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818257",
            "telephone_number": "330-227-4518",
            "fax_number": "855-975-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1392 HIGH ST STE 205",
            "city": "WADSWORTH",
            "state": "OH",
            "postal_code": "442818257",
            "telephone_number": "330-227-4518",
            "fax_number": "855-975-3166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "246 Northland Dr Ste 200A",
            "address_purpose": "LOCATION",
            "city": "Medina",
            "state": "OH",
            "postal_code": "442561533",
            "country_code": "US",
            "telephone_number": "330-725-9195",
            "fax_number": "330-725-9187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELLERS",
        "first_name": "CARRIE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-23",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 0700059-S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0369772",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadsworth, OH

Sources for this page

Verify at the official NPI Registry.