Pamela Raber, LCSW

Individual provider Active NPI Clinical Social Worker · Coal City, IL

NPI 1154862845 · NPPES record last updated Apr 22, 2020

Key facts

NPI
1154862845
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
149.076991 (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
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

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, LLC (9 clinicians)

Practice addresses (Care Compare)

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210723002622 SC Practitioner - Clinical Social Worker 0143505529 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
149.076991ILMDClinical Social Worker
13576SCMDMassage Therapist

Practice roles

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

Locations

20 Towne Dr
Bluffton, SC 29910
Phone (843) 441-9208

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

Interoperability endpoints

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.076991 IL Yes

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

Other providers in Coal City, IL

All providers in Coal City, IL · Clinical Social Worker in Illinois

Sources for this page

Verify at the official NPI Registry.