Active NPI
Charell G Schillo, LICSW
- Clinical Social Worker
- Williston, ND
National Provider Identifier
1376653527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 526
- Practice address
- 316 2ND Ave W
Williston, ND 58801 - Phone
- (701) 774-4600
- Fax
- (701) 774-4620
- NPI assigned
- Aug 30, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 526 | ND | Primary |
| Clinical Social Worker | 1041C0700X | 123500-3502 | UT |
Addresses
Primary practice location
316 2ND Ave W
Williston, ND 58801
Mailing address
Box 874
Williston, ND 58802
Phone (701) 774-4646
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 79232 | Medicaid | ND | |
| 019075 | Other | ND | BC/BS |
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 |
|---|---|---|---|
| 123500-3502 | UT | MD | Clinical Social Worker |
| 526 | ND | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376653527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BOX 874",
"city": "WILLISTON",
"state": "ND",
"postal_code": "58802",
"telephone_number": "701-774-4646",
"fax_number": "701-774-4620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 2ND AVE W",
"city": "WILLISTON",
"state": "ND",
"postal_code": "58801",
"telephone_number": "701-774-4600",
"fax_number": "701-774-4620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHILLO",
"first_name": "CHARELL",
"middle_name": "G",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ND",
"license": "526",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "UT",
"license": "123500-3502",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "79232",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "019075",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williston, ND
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.