Individual provider Active NPI

Pamela Jane Root-Baechle, LCSW

  • Mental Health Counselor
  • Hollidaysburg, PA
National Provider Identifier
1114029568
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CW-002127-L Issued in PA
Practice address
509 Allegheny St
Hollidaysburg, PA 16648-2012
Phone
(814) 695-2776
Fax
(814) 693-9865
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CW-002127-L PA Primary

Addresses

Primary practice location

509 Allegheny St
Hollidaysburg, PA 16648-2012

Mailing address

408 Union St
Hollidaysburg, PA 16648-1518
Phone (814) 695-2776

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
I20101208000763 PA Practitioner - Clinical Social Worker 9931396512 Practice locations: Hollidaysburg, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

408 Union St
Hollidaysburg, PA 16648-1518

509 Allegheny St
Hollidaysburg, PA 16648-2012
Phone (814) 695-2776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW-002127-LPAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wiley Corporation Past Accepting new patients
Marcy Rowland PHD LLC PastSince May 9, 2011 Accepting new patients

Organizations & group practices 2

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114029568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 UNION ST",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166481518",
            "telephone_number": "814-695-2776",
            "fax_number": "814-693-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 ALLEGHENY ST",
            "city": "HOLLIDAYSBURG",
            "state": "PA",
            "postal_code": "166482012",
            "telephone_number": "814-695-2776",
            "fax_number": "814-693-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOT-BAECHLE",
        "first_name": "PAMELA",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "CW-002127-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollidaysburg, PA

Sources for this page

Verify at the official NPI Registry.