Individual provider Active NPI

Paulette Decarlo, LISW

  • Clinical Social Worker
  • Youngstown, OH
National Provider Identifier
1508985854
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-9900 Issued in OH
Practice address
310 Churchill Hubbard Rd
Suite a
Youngstown, OH 44505-1371
Phone
(330) 759-3040
Fax
(330) 759-3070
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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-9900 OH Primary

Addresses

Primary practice location

310 Churchill Hubbard Rd
Suite a
Youngstown, OH 44505-1371

Mailing address

302 Maplewood Ave
Struthers, OH 44471-1819

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-9900OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trumbull Mahoning Medical Group, Inc. Past Accepting new patients
Churchill Counseling Services, Inc PastSince Jan 26, 1996 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508985854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 MAPLEWOOD AVE",
            "city": "STRUTHERS",
            "state": "OH",
            "postal_code": "444711819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CHURCHILL HUBBARD RD",
            "address_2": "SUITE A",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051371",
            "telephone_number": "330-759-3040",
            "fax_number": "330-759-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARLO",
        "first_name": "PAULETTE",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-9900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

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.

Verify at the official NPI Registry.