Individual provider Active NPI

Pamela Raber, LCSW

  • Clinical Social Worker
  • Coal City, IL
National Provider Identifier
1154862845
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.076991 Issued in IL
Practice address
40 N Broadway St
Coal City, IL 60416-1688
Phone
(630) 352-7267
Fax
(779) 234-6513
NPI assigned
Mar 14, 2017
Last updated
Apr 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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 149.076991 IL Primary

Addresses

Primary practice location

40 N Broadway St
Coal City, IL 60416-1688

Mailing address

105 E Galena Blvd FL 3
Aurora, IL 60505-3338
Phone (866) 830-0450

Other practice location 1

35445 Washington St
Custer Park, IL 60481-9115
Phone (630) 352-7267

Other practice location 2

11965 S Aero Dr Ste A
Plainfield, IL 60585-9712
Phone (630) 362-5777

Other practice location 3

105 E Galena Blvd Fl 3
Aurora, IL 60505-3338
Phone (866) 830-0450

Other practice location 4

740 E Division St
Coal City, IL 60416-1337
Phone (630) 362-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20210723002622 SC Practitioner - Clinical Social Worker 0143505529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Therapy Group, LLCGroup PAC ID 8123361730, 9 clinicians

Practice addresses (Care Compare)

1555 Fording Island Rd
Suite C1
Hilton Head Island, SC 29926-1176
Phone (843) 815-6789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.076991ILMDClinical Social Worker
13576SCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Therapy Group, LLC Clinical CurrentSince Jun 1, 2021 Accepting new patients
Brave Health Medical Group PA Past Accepting new patients

Locations

20 Towne Dr
Bluffton, SC 29910
Phone (843) 605-0722

1555 Fording Island Rd
Ste C1
Hilton Head Island, SC 29926
Phone (843) 815-6789

Interoperability endpoints

  • Direct secure messaging: pamelaraber@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1154862845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E GALENA BLVD FL 3",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605053338",
            "telephone_number": "866-830-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 N BROADWAY ST",
            "city": "COAL CITY",
            "state": "IL",
            "postal_code": "604161688",
            "telephone_number": "630-352-7267",
            "fax_number": "779-234-6513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35445 Washington St",
            "address_purpose": "LOCATION",
            "city": "Custer Park",
            "state": "IL",
            "postal_code": "604819115",
            "country_code": "US",
            "telephone_number": "630-352-7267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11965 S Aero Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Plainfield",
            "state": "IL",
            "postal_code": "605859712",
            "country_code": "US",
            "telephone_number": "630-362-5777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "105 E Galena Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605053338",
            "country_code": "US",
            "telephone_number": "866-830-0450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "740 E Division St",
            "address_purpose": "LOCATION",
            "city": "Coal City",
            "state": "IL",
            "postal_code": "604161337",
            "country_code": "US",
            "telephone_number": "630-362-5777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RABER",
        "first_name": "PAMELA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.076991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coal City, IL

Sources for this page

Verify at the official NPI Registry.