Centerville Clinics Inc

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

Legal business name

CENTERVILLE CLINICS INC

Practice address

California High School
11 Trojan Way
Coal Center, PA 15423-1059

Phone

(724) 785-5800

NPI assigned

Jul 16, 2018

Last updated

Aug 24, 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

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gail Eileen Killmeyer

  • Social Worker
  • Pittsburgh, PA
  • NPI 1134193550
  NPD (past)
• Kalynn Marie Wheeland, MS, LAT, ATC

  • Athletic Trainer
  • Coal Center, PA
  • NPI 1255967485
  NPD (past)

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535068800000",
    "number": "1871079566",
    "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": "CALIFORNIA HIGH SCHOOL",
            "address_2": "11 TROJAN WAY",
            "city": "COAL CENTER",
            "state": "PA",
            "postal_code": "154231059",
            "telephone_number": "724-785-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE CLINICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-08-24",
        "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": "",
            "desc": "Social Worker, School",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007288440027",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dawn Altman
• Charisse Regene Bowman, LCSW
• Centerville Clinics Inc
• Centerville Clinics Inc
• Kate Anne Ducarme, MPAS, PA-C
• Danielle Hammitt, MS, LPC, NCC
• Intermediate Unit 1
• Intermediate Unit 1

• School Social Worker in Coal Center, PA
• Providers in Coal Center, 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 Aug 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.

Verify at the official NPI Registry.