Centerville Clinics Inc

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

Legal business name

CENTERVILLE CLINICS INC

Practice address

Beth Center Middle School
136 Crawford Road
Fredericktown, PA 15333

Phone

(724) 267-4935

Fax

(724) 267-4937

NPI assigned

Jul 12, 2018

Last updated

Jul 12, 2018By the provider in NPPES

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

Locations

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": "1760968853",
    "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": "BETH CENTER MIDDLE SCHOOL",
            "address_2": "136 CRAWFORD ROAD",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "15333",
            "telephone_number": "724-267-4935",
            "fax_number": "724-267-4937"
        }
    ],
    "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": "193400000X SINGLE 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": []
}

• Bethlehem-Center School District
• Roselyn Elizabeth Carozza, DMD
• Centerville Clinics , Inc.
• Centerville Clinics , Inc.
• Centerville Clinics Inc
• Centerville Clinics Inc
• Centerville Clinics Inc.
• Centerville Clinics Ins Dental
• Centerville Clinics, Inc
• Centerville Clinics, Inc

• School Social Worker in Fredericktown, PA
• Providers in Fredericktown, 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 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.