Wormack Inc.

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

WORMACK INC.

Practice address

201 E Fairview Ave
Suite 206, 2ND Floor
Connellsville, PA 15425-3703

Phone

(724) 570-3556

NPI assigned

Feb 13, 2014

Last updated

Jan 18, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

WORMACK INC.As reported in NPPES

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

Authorized official

Name

Mr. Raymond D. Wormack, LCSWNPI 1841419546

Title

Ceo

Phone

(724) 570-3556

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Part of

Wormack Inc

Locations

Practitioners 1

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.

• Raymond Daniel Wormack, LCSW

  • Clinical Social Worker
  • Connellsville, PA
  • NPI 1841419546
  Authorized official Same address or phone

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

{
    "created_epoch": "1392249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484697600000",
    "number": "1144644915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SNYDER ST",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253448",
            "telephone_number": "724-626-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E FAIRVIEW AVE",
            "address_2": "SUITE 206, 2ND FLOOR",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154253703",
            "telephone_number": "724-570-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORMACK INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WORMACK INC.",
        "enumeration_date": "2014-02-13",
        "last_updated": "2017-01-18",
        "status": "A",
        "authorized_official_last_name": "WORMACK",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "724-570-3556",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Lorraine Wilhelm, LCSW
• Richonda Williams
• Tyler Williams
• Michael Brent Wilson, PHARM.D.
• Wormack Caring Place Corp (WCPC)
• Raymond Daniel Wormack, LCSW
• Alex Yazhbin, M.D.

• Voluntary or Charitable Agency in Connellsville, PA
• Providers in Connellsville, PA by specialty
• Voluntary or Charitable Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.