Centerville Clinics Inc

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

Legal business name

CENTERVILLE CLINICS INC

Practice address

Peters Township High School
264 East McMurray Road
McMurray, PA 15317

Phone

(724) 941-6250

Fax

(724) 942-0915

NPI assigned

Apr 10, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Barry R Niccolai

Title

Executive Director

Phone

(724) 632-6801

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1578026191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CENTERVILLE CLINICS INC",
            "address_2": "1070 OLD NATIONAL PIKE ROAD",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801",
            "fax_number": "724-632-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PETERS TOWNSHIP HIGH SCHOOL",
            "address_2": "264 EAST MCMURRAY ROAD",
            "city": "MCMURRAY",
            "state": "PA",
            "postal_code": "15317",
            "telephone_number": "724-941-6250",
            "fax_number": "724-942-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-10",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "NICCOLAI",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "724-632-6801",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288440027",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• School Social Worker in McMurray, PA
• Providers in McMurray, PA by specialty
• School Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.