NPIMap

Organization Active NPI

Healing Room Inc.

  • Clinical Social Worker
  • State College, PA
National Provider Identifier
1033501523
Registry record updated Mar 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017193 Issued in PA
Legal business name
HEALING ROOM INC.
Practice address
2023 Cato Ave
Suite 101
State College, PA 16801-2765
Phone
(814) 599-4124
NPI assigned
Feb 20, 2015
Last updated
Mar 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2015

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

Authorized official

Name
Katherine Gates-Moore, LCSWNPI 1205088267
Title
Co-Owner
Phone
(814) 599-4124

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC006863 PA
Clinical Social Worker 1041C0700X CW017193 PA Primary

Addresses

Primary practice location

2023 Cato Ave
Suite 101
State College, PA 16801-2765

Mailing address

2023 Cato Ave
Suite 101
State College, PA 16801-2765
Phone (814) 599-4124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150508000947 PA Part B Supplier - Clinic/Group Practice 0345569653 Receives reassigned benefits from 1 practitioner
Practice locations: State College, PA

National Provider Directory

National Provider Directory

Locations

1951 Pine Hall Rd
Ste 100
State College, PA 16801
Phone (814) 248-5855

2023 Cato Ave
#101
State College, PA 16801
Phone (814) 308-8375

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425254400000",
    "number": "1033501523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 CATO AVE",
            "address_2": "SUITE 101",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012765",
            "telephone_number": "814-599-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 CATO AVE",
            "address_2": "SUITE 101",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168012765",
            "telephone_number": "814-599-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING ROOM INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-20",
        "last_updated": "2015-03-02",
        "status": "A",
        "authorized_official_last_name": "GATES-MOORE",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "814-599-4124",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC006863",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.