Active NPI
Centerville Clinics, Inc
- School Social Worker
- Washington, PA
National Provider Identifier
1780182873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- Legal business name
- CENTERVILLE CLINICS, INC
- Practice address
- 252 Cameron Road
Trinity East Elementary School
Washington, PA 15301 - Phone
- (724) 225-8140
- NPI assigned
- Jan 24, 2018
- Organization subpart
- No
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | PA | Primary |
Addresses
Primary practice location
252 Cameron Road
Trinity East Elementary School
Washington, PA 15301
Mailing address
1070 Old National Pike Road
Fredericktown, PA 15333-2114
Phone (724) 632-6801
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007288440027 | Medicaid | PA |
National Provider Directory
National Provider DirectoryLocations
252 Cameron Rd
Washington, PA 15301
Phone (724) 225-8140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516752000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1516752000000",
"number": "1780182873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "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": "252 CAMERON ROAD",
"address_2": "TRINITY EAST ELEMENTARY SCHOOL",
"city": "WASHINGTON",
"state": "PA",
"postal_code": "15301",
"telephone_number": "724-225-8140"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTERVILLE CLINICS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-24",
"last_updated": "2018-01-24",
"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": []
}Other providers in Washington, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.