Individual provider Active NPI

Carley Trillow, LSW , MSW, LICDC

  • Social Worker
  • Wooster, OH
National Provider Identifier
1457851792
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1903309 Issued in OH
Practice address
2000 Noble Dr
Wooster, OH 44691-5353
Phone
(330) 264-3232
NPI assigned
Feb 13, 2018
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S.1903309 OH
Substance Abuse Rehabilitation Facility 324500000X 164574 OH
Social Worker 104100000X 1903309 OH Primary

Addresses

Primary practice location

2000 Noble Dr
Wooster, OH 44691-5353

Mailing address

2000 Noble Dr
Wooster, OH 44691-5353
Phone (330) 264-3232

Other practice location 1

4930 Enterprise Dr NW
Warren, OH 44481-8706
Phone (330) 787-0955

Other practice location 2

6140 S Broadway
Lorain, OH 44053-3891
Phone (440) 204-4315

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

LicenseStateTypeSpecialty
1903309OHMDSocial Worker
S.1903309OHMDSocial Worker
164574OHMDSubstance Abuse Rehabilitation Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Brighter Days Recovery Counseling LLC Current Accepting new patients
FSR of Parkman LLC PastSince Sep 18, 2024 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/parkmanrecovery/r4/

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1457851792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NOBLE DR",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446915353",
            "telephone_number": "330-264-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4930 Enterprise Dr NW",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "OH",
            "postal_code": "444818706",
            "country_code": "US",
            "telephone_number": "330-787-0955",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6140 S Broadway",
            "address_purpose": "LOCATION",
            "city": "Lorain",
            "state": "OH",
            "postal_code": "440533891",
            "country_code": "US",
            "telephone_number": "440-204-4315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRILLOW",
        "first_name": "CARLEY",
        "credential": "LSW , MSW, LICDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1903309",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "OH",
            "license": "164574",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "1903309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.