Monica Carol Petrilla, LISW-S

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I-0008340 Issued in OH

Practice address

3821 Starrs Centre Dr
Suite B
Canfield, OH 44406-8003

Phone

(330) 533-3102

Fax

(330) 533-3123

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Behavioral Health LLCGroup PAC ID 9234364878, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northeast Behavioral Health LLC

  • Psychiatry Physician
  • Canfield, OH
  • NPI 1871838474
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1407975238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 STARRS CENTRE DR",
            "address_2": "SUITE B",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068003",
            "telephone_number": "330-533-3102",
            "fax_number": "330-533-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 STARRS CENTRE DR",
            "address_2": "SUITE B",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068003",
            "telephone_number": "330-533-3102",
            "fax_number": "330-533-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLA",
        "first_name": "MONICA",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I-0008340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000503675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayleigh Perline
• Angelo Peroulakis
• Sheldon Persky, D.D.S.
• Kimberly Peterson, RN
• Gianna Elizabethh Petrella
• Alyssa Phillips
• Cliff Delmar Phillips
• Jacquelyn K Phillips, LD
• Tamara Lynne Pierson
• Agustina Pinto Gonzalez

• Social Worker in Canfield, OH
• Providers in Canfield, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.