Courtney Pelham

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.2005034 Issued in OH

Practice address

800 Market Ave N
Canton, OH 44702-1083

Phone

(330) 247-3994

NPI assigned

Jul 6, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633

  Social Worker

  Medicare reassignment NPD

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1801413984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3012 TREESIDE ST NW APT C",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447091951",
            "telephone_number": "419-371-5670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MARKET AVE N",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021083",
            "telephone_number": "330-247-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELHAM",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2005034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "NYAP.org",
            "affiliation": "N",
            "address_1": "800 Market Ave N",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447021083",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tabitha Joy Pearson
• Rachel Pecora, LMT
• Pediatric Center of Canton, LLC
• Peer Compassion LLC
• Davina Dawniell Pelfrey
• Leslian Pellicier
• Hollie Pena
• Hsiao CHI Peng
• Allison Renee Pennington
• Nicole Penny

• Social Worker in Canton, OH
• Providers in Canton, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.