Individual provider Active NPI

Karen Kiriazis, LISW

  • Clinical Social Worker
  • Youngstown, OH
National Provider Identifier
1902899701
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-4376 Issued in OH
Practice address
310 Churchill Hubbard Rd
Suite a
Youngstown, OH 44505-1371
Phone
(330) 759-3040
Fax
(330) 759-3070
NPI assigned
Aug 26, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-4376 OH Primary

Addresses

Primary practice location

310 Churchill Hubbard Rd
Suite a
Youngstown, OH 44505-1371

Mailing address

310 Churchill Hubbard Rd
Suite a
Youngstown, OH 44505-1371
Phone (330) 759-3040

Other identifiers 3

IdentifierTypeStateIssuer
155347000OtherOHMAGELLAN
0811787MedicaidOH
000000250391OtherOHANTHEM

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080611000001 OH Practitioner - Clinical Social Worker 2466523956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-4376OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Churchill Counseling Services, Inc CurrentSince Jan 26, 1996 Accepting new patients
Trumbull Mahoning Medical Group, Inc. PastSince Jan 26, 1996 Accepting new patients
Compass Family and Community Services Past Accepting new patients
Compass Family and Community Services Past Accepting new patients

Locations

4531 Belmont Ave
Ste 8
Youngstown, OH 44505
Phone (330) 759-0099

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1902899701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CHURCHILL HUBBARD RD",
            "address_2": "SUITE A",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051371",
            "telephone_number": "330-759-3040",
            "fax_number": "330-759-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CHURCHILL HUBBARD RD",
            "address_2": "SUITE A",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051371",
            "telephone_number": "330-759-3040",
            "fax_number": "330-759-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRIAZIS",
        "first_name": "KAREN",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-26",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-4376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "155347000",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0811787",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000250391",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.