Individual provider Active NPI

Sandra E Perrotta, MSED, LPCC

  • Counselor
  • Boardman, OH
National Provider Identifier
1972566586
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
E.0003650 Issued in OH
Practice address
725 Boardman Canfield Rd # BC3
Boardman, OH 44512-4380
Phone
(330) 559-3069
NPI assigned
Apr 7, 2006
Last updated
Jan 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X E.0003650 OH Primary

Addresses

Primary practice location

725 Boardman Canfield Rd # BC3
Boardman, OH 44512-4380

Mailing address

725 Boardman Canfield Rd # BC3
Boardman, OH 44512-4380
Phone (330) 559-3069

Other practice location 1

1 Perkins Sq
Akron, OH 44308-1063
Phone (330) 543-7472

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
I20240322000216 OH Practitioner - Mental Health Counselor 4880031186 Reassigns benefits to 1 organization
Practice locations: Boardman, OH

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rajendra P Koirala, M.D., LLCGroup PAC ID 8820334931, 23 clinicians

Practice addresses (Care Compare)

725 Boardman Canfield Rd
Suite L1
Boardman, OH 44512-4370
Phone (330) 330-8655

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.0003650OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rajendra P Koirala, M.D., LLC CurrentSince May 1, 2025 Accepting new patients

Locations

725 Boardman Canfield Rd
Ste L1
Youngstown, OH 44512
Phone (330) 330-8655

725 Boardman Canfield Rd
Ste M2
Youngstown, OH 44512
Phone (330) 330-8655

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1972566586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD # BC3",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-559-3069",
            "fax_number": "330-543-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD # BC3",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-559-3069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Perkins Sq",
            "address_purpose": "LOCATION",
            "city": "Akron",
            "state": "OH",
            "postal_code": "443081063",
            "country_code": "US",
            "telephone_number": "330-543-7472",
            "fax_number": "330-543-7474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERROTTA",
        "first_name": "SANDRA",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MSED, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E.0003650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.