Carol Ann Pelegrin, L.I.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I 0005886 Issued in OH

Practice address

3591 Reserve Commons Dr
Suite 301
Medina, OH 44256-5334

Phone

(330) 764-7916

Fax

(330) 723-6399

NPI assigned

Aug 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

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

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.

• Psychology Consultants Inc

  • Clinical Social Worker
  • Medina, OH
  • NPI 1205882941
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1639325541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR",
            "address_2": "SUITE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3591 RESERVE COMMONS DR",
            "address_2": "SUITE 301",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565334",
            "telephone_number": "330-764-7916",
            "fax_number": "330-723-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELEGRIN",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "L.I.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I 0005886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Pearson
• Tiffany Peets, LPC
• Jenna Ann Pelfrey
• Michael Patrick Pelini, PA-C
• Kaylynn M Pember, RN
• Performance Therapy Group, Inc.
• Amber Perkins, PRS CDCA 699

• Clinical Social Worker in Medina, OH
• Providers in Medina, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; 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.