Organization Active NPI

Beyond Counseling Center, LLC

  • Clinical Social Worker
  • Bloomsburg, PA
National Provider Identifier
1235625716
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018964 Issued in PA
Legal business name
BEYOND COUNSELING CENTER, LLC
Practice address
16 Sherwood Drive
Suite C
Bloomsburg, PA 17815-3086
Phone
(570) 204-4028
Fax
(570) 445-2214
NPI assigned
Jul 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Authorized official

Name
Mrs. Pamela Rose Cosper, LCSWNPI 1740669183
Title
Licensed Clinical Social Worker
Phone
(570) 204-4028

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CW018964 PA Primary

Addresses

Primary practice location

16 Sherwood Drive
Suite C
Bloomsburg, PA 17815-3086

Mailing address

16 Sherwood Drive
Suite C
Bloomsburg, PA 17815-3086
Phone (570) 204-4028

Other identifiers 2

IdentifierTypeStateIssuer
1035723800001MedicaidPA
0019468810006MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180913002290 PA Part B Supplier - Clinic/Group Practice 8729338660 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomsburg, PA

National Provider Directory

National Provider Directory

Locations

16 Sherwood Dr
Ste C
Bloomsburg, PA 17815
Phone (570) 204-4028

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1531008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556496000000",
    "number": "1235625716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SHERWOOD DRIVE",
            "address_2": "SUITE C",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178153086",
            "telephone_number": "570-204-4028",
            "fax_number": "570-445-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SHERWOOD DRIVE",
            "address_2": "SUITE C",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178153086",
            "telephone_number": "570-204-4028",
            "fax_number": "570-445-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEYOND COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-08",
        "last_updated": "2019-04-29",
        "status": "A",
        "authorized_official_last_name": "COSPER",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "570-204-4028",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035723800001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019468810006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2019; 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.