Individual provider Active NPI

Sue Jane Roh

  • Clinical Social Worker
  • Blue Bell, PA
National Provider Identifier
1083480552
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW024192 Issued in PA
Practice address
1749 Hallman Dr
Blue Bell, PA 19422-3576
Phone
(610) 864-5476
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 CW024192 PA Primary

Addresses

Primary practice location

1749 Hallman Dr
Blue Bell, PA 19422-3576

Mailing address

678 W St
King of Prussia, PA 19406-2704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240307002961 PA Practitioner - Clinical Social Worker 0648629907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling and Wellness LLCGroup PAC ID 3577977362, 5 clinicians

Practice addresses (Care Compare)

Blue Bell, PA 19422
Phone (610) 864-5476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW024192PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling and Wellness LLC Clinical CurrentSince Mar 4, 2024 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1083480552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 W ST",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194062704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 HALLMAN DR",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194223576",
            "telephone_number": "610-864-5476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROH",
        "first_name": "SUE",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW024192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Bell, PA

Sources for this page

Verify at the official NPI Registry.