Individual provider Active NPI

Carole Clowser Serbin, LCSW

  • Social Worker
  • Indiana, PA
National Provider Identifier
1164417663
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CW001067E Issued in PA
Practice address
290 Grant St
Indiana, PA 15701-3764
Phone
(814) 341-4389
Fax
(724) 801-8153
NPI assigned
Sep 12, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CW001067E PA Primary

Addresses

Primary practice location

290 Grant St
Indiana, PA 15701-3764

Mailing address

290 Grant St
Indiana, PA 15701-3764
Phone (814) 341-4389

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
I20050218000479 PA Practitioner - Clinical Social Worker 1850343716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

290 Grant St
Indiana, PA 15701-3764
Phone (814) 341-4389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW001067EPAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Croyle-Serbin Therapeutic Associates, PC CurrentSince Jul 1, 2008 Accepting new patients
Croyle-Serbin Therapeutic Associates, P.C. Past Accepting new patients
Croyle-Serbin Therapeutic Associates, PC Past Accepting new patients

Locations

1450 Scalp Ave
Ste 209
Johnstown, PA 15904
Phone (814) 266-3196

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.

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1164417663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 GRANT ST",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013764",
            "telephone_number": "814-341-4389",
            "fax_number": "724-801-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 GRANT ST",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013764",
            "telephone_number": "814-341-4389",
            "fax_number": "724-801-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERBIN",
        "first_name": "CAROLE",
        "middle_name": "CLOWSER",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-12",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "CW001067E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indiana, PA

Sources for this page

Verify at the official NPI Registry.