Jane Back, LMCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW019049 Issued in PA

Practice address

850 W Lancaster Ave
2ND Floord
Bryn Mawr, PA 19010-3220

Phone

(610) 520-1510

Fax

(610) 520-1517

NPI assigned

Sep 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Resources for Human Development, Inc.

  • Community/Behavioral Health Agency
  • Bryn Mawr, PA
  • NPI 1548395585

  PA

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, PA

  Medicare reassignment NPD
• Holistic Change Counseling

  • Community/Behavioral Health Agency
  • Southampton, PA
  • NPI 1033815717
  NPD Authorized official
• North Star Counseling

  • Clinical Social Worker
  • Southampton, PA
  • NPI 1629567581

  Clinical

  NPD Authorized official
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1356335129
  NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1689357782
  NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1043204811
  NPD (past)

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1265981963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 KINGFIELD RD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154011",
            "telephone_number": "347-377-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 W LANCASTER AVE",
            "address_2": "2ND FLOORD",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103220",
            "telephone_number": "610-520-1510",
            "fax_number": "610-520-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACK",
        "first_name": "JANE",
        "credential": "LMCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert R Atkins, M.D.
• Raymond B Attolino, DO
• Abbe Bernstein Avart, MSPT
• Maura Kristen Ayers, PT
• Anastasia Babouchkina
• Peter C Badgio, PH.D.
• Marc D Baer, DPM
• Stephen K Baker, MD
• Michael Baloga, DPM
• Bancroft Neurohealth

• All providers in Bryn Mawr, PA
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.