KARLA A. MELLOTT (LISW) – Clinical Social Worker, NPI 1063638070

KARLA A. MELLOTT (LISW) is a healthcare provider. based in Tallmadge, Ohio. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LISW. They hold a License No. I 0032005 (OH). The NPI Number for KARLA A. MELLOTT (LISW) is 1063638070

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
KARLA A. MELLOTT (LISW)
NPI
1063638070
Phone
(330) 414-0808
Address
219 WHITTLESEY DR
Enumeration Date
18 April 2007
Last Update Date
6 March 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3304422664
Graduation Year
2004 (22 years ago)
PAC ID
3678936374
Group Practice PAC ID
1951712066
Professional Enrollment ID
I20230829000924
Address ID
OH447202858NO1303XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,650 CLINICAL SOCIAL WORKER in OH

Provider Addresses for KARLA A. MELLOTT (LISW)

  • 219 WHITTLESEY DR

    TALLMADGE, OH 442781653

    Phone: (330) 414-0808

    Type: Mailing

  • 1 PERKINS SQ

    AKRON, OH 443081063

    Phone: (330) 543-1000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-08-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230829000924IClinical Social WorkerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44278)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951712066View full group profile
NameSpecialtyState
Clinical Social WorkerOH
Nurse PractitionerOH
Mental Health CounselorOH
Nurse PractitionerOH
Nurse PractitionerOH
Mental Health CounselorOH
Clinical Social WorkerOH
Clinical PsychologistMO
Clinical Social WorkerOH
Nurse PractitionerOH

Reviews

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Frequently asked questions

What is the 10-digit NPI for KARLA A. MELLOTT (LISW)?
KARLA A. MELLOTT (LISW) — NPI 1063638070 — is the standard way to identify this listing.
Does CMS list KARLA A. MELLOTT (LISW) as active?
Yes — KARLA A. MELLOTT (LISW) is active in the NPI listing used on this page.
What is KARLA A. MELLOTT (LISW) best known for clinically?
Directory data describes KARLA A. MELLOTT (LISW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Does KARLA A. MELLOTT (LISW) list a practice location?
Patients near Tallmadge, Ohio may find KARLA A. MELLOTT (LISW) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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