Centerville Clinics Inc

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

Legal business name

CENTERVILLE CLINICS INC

Practice address

West Greene Middle/Senior HS
1367 Hargus Creek Road
Waynesburg, PA 15370

Phone

(724) 499-5183

NPI assigned

Jul 12, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Barry Niccolai

Title

Executive Director

Phone

(724) 632-6801

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1639655673",
    "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": "WEST GREENE MIDDLE/SENIOR HS",
            "address_2": "1367 HARGUS CREEK ROAD",
            "city": "WAYNESBURG",
            "state": "PA",
            "postal_code": "15370",
            "telephone_number": "724-499-5183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "NICCOLAI",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "724-632-6801",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288440027",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann-Marie J Caron, PT, CSCS
• Samantha Carter, MPT
• Alan Thomas Casciola, D.O.
• Center for Community Resources, Inc.
• Centerville Clinics Inc
• Centerville Clinics, Inc Central Greene SC
• Centerville Clinics, Inc Waysburg Pace
• Centerville Clinics, Inc.
• Centerville Clinics, Inc.
• Centerville Clinics, Inc.

• All providers in Waynesburg, PA
• School Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.