MRS. CARLA SUE NICHOLAS (NPI# 1104947449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104947449 |
| Entity Type | Individual |
| Full Name | MRS. CARLA SUE NICHOLAS |
| Credential | OCCUPATIONAL THERAPI |
| Practice Address |
7620 Southern Blvd Ste 3 Boardman OH 44512-5667 |
| Mailing Address |
1397 S Canfield Niles Rd Unit 1 Austintown OH 44515-4084 |
| Practice Telephone | 3309659330 |
| Practice Fax Number | 3309659308 |
| Mailing Telephone | 3309530129 |
| Mailing Fax Number | 3309530650 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2016-11-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | OT-03869 | OH | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0956112 | 05 |
| Street Address |
7620 SOUTHERN BLVD STE 3 |
| City | BOARDMAN |
| State | OH |
| Zip Code | 44512-5667 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316937824 | Ryan R Tessean | Physical Therapist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2005-10-26 |
| 1386005544 | Diana Wachsberger | Speech-Language Pathologist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2016-03-16 |
| 1922405851 | Kelley Shaughnessy | Massage Therapist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2014-11-20 |
| 1528477288 | Southwoods Rehabilitation LLC | Occupational Therapist | 7620 Southern Blvd, Suite 3, Boardman, OH 44512-5667 | 2014-08-07 |
| 1598194615 | Janis Cope | Occupational Therapist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2013-11-08 |
| 1477891596 | Jeanne Cotters Monroe | Speech-Language Pathologist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2013-01-24 |
| 1215291430 | Sheri Owen | Physical Therapist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2012-07-03 |
| 1417226739 | Janice Szari | Speech-Language Pathologist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2011-12-15 |
| 1548543499 | Wendy Kennedy | Speech-Language Pathologist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2011-09-27 |
| 1770866626 | Tracy Morton | Speech-Language Pathologist | 7620 Southern Blvd, Ste 3, Boardman, OH 44512-5667 | 2011-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248740 | Kimberly Vrabel | Counselor | 725 Boardman Canfield Road Road Unit 1 and Unit 2, Boardman, OH 44512 | 2020-09-02 |
| 1043830144 | Steffi Lorraine D'souza | Student in an Organized Health Care Education/Training Program | 8423 Market Street Suite 101 St. Elizabeth Boardman Hos, Boardman, OH 44512 | 2020-04-20 |
| 1427677830 | Shivani Sharma | Family Medicine | 8423 Market Street Suite 101, St Elizabeth Boardman Hospital, Boardman, OH 44512 | 2020-04-15 |
| 1417587825 | Ronny Zetts | Pharmacist | 308 Boardman-canfield Rd, Boardman, OH 44512 | 2020-01-24 |
| 1285105080 | Andrew Dawson | Nurse Practitioner | 883 Boardman Canfield Rd Ste 105, Youngstown, OH 44512 | 2018-12-06 |
| 1700374949 | Adam Leid | Student in an Organized Health Care Education/Training Program | St Elizabeth Boardman Hospital - Medical Education Dept, 8401 Market Street, Boardman, OH 44512 | 2018-04-24 |
| 1528574910 | Herman Frank IIi | Licensed Practical Nurse | 920 Boardman Canfield Road, Boardman, OH 44512 | 2017-12-20 |
| 1730601980 | Stephanie Ann Mathews | Nurse Practitioner | 7600 Southern Blvd #1, Boardman, OH 44512 | 2017-07-10 |
| 1417485079 | Telka Ghobadi | Family Medicine | 8423 Market St., Suite 101, Boardman, OH 44512 | 2017-05-26 |
| 1356797534 | Haroon Hussain Syed | Student in an Organized Health Care Education/Training Program | 8423 Market Street, St. Elizabeth Boardman Hospital, Boardman, OH 44512 | 2016-05-06 |
| Find all providers in zip 44512 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205344405 | Eopt Boardman Pllc | Occupational Therapist | 101 Sw Kinkade Rd, Boardman, OR 97818-9001 | 2018-01-22 |
| 1164846556 | Shannon Mulichak | Occupational Therapist | 1480 Barbie Dr, Boardman, OH 44512-3732 | 2014-02-06 |
| 1881888410 | Living Independently, LLC | Occupational Therapist | 4536 Simon Rd, Boardman, OH 44512-1730 | 2007-08-27 |
| 1558453555 | Jennifer Anna Lassonde | Occupational Therapist | 100 Debartolo Pl, Suite 200, Boardman, OH 44512-7011 | 2006-09-28 |
| 1467065813 | Marycatherine Horne | Occupational Therapist | 835 Mckay Ct Ste 100, Boardman, OH 44512-5786 | 2020-08-26 |
| 1083251342 | Shannon Lee Montgomery | Occupational Therapist | 835 Mckay Ct Ste 100, Boardman, OH 44512-5786 | 2019-12-05 |
| 1598312696 | Stacia Jo Macchia | Occupational Therapist | 835 Mckay Ct Ste 100, Boardman, OH 44512-5786 | 2019-08-22 |
| 1356717771 | Taylor M Haseley | Occupational Therapist | 8049 South Ave, Boardman, OH 44512-6154 | 2015-08-19 |
| 1275936940 | Paige Genova | Occupational Therapist | 1265 Boardman Canfield Rd, Boardman, OH 44512-4004 | 2014-10-08 |
| 1528477288 | Southwoods Rehabilitation LLC | Occupational Therapist | 7620 Southern Blvd, Suite 3, Boardman, OH 44512-5667 | 2014-08-07 |
| Find all providers in BOARDMAN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.