Calsandra A Marinchick, CCHW

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

CHW.000462 Issued in OH

Practice address

630 21St St NW
Canton, OH 44709-3869

Phone

(330) 309-3341

Fax

(330) 437-3717

NPI assigned

Jul 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494979200000",
    "number": "1760899496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 21ST ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093869",
            "telephone_number": "330-309-3341",
            "fax_number": "330-437-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 21ST ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447093869",
            "telephone_number": "330-309-3341",
            "fax_number": "330-437-3717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINCHICK",
        "first_name": "CALSANDRA",
        "middle_name": "A",
        "credential": "CCHW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2017-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OH",
            "license": "CHW.000462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3090980",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Canton, OH
• Providers in Canton, OH by specialty
• Community Health Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.