Individual provider Active NPI

Thomas J Sheeran III, LCSW

  • Clinical Social Worker
  • Montrose, PA
National Provider Identifier
1285698340
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW014249 Issued in PA
Practice address
Lake Plaza 2 Route 706 E
Montrose, PA 18801-0285
Phone
(570) 278-3393
Fax
(570) 278-1716
NPI assigned
Apr 14, 2006
Last updated
Apr 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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 CW014249 PA Primary

Addresses

Primary practice location

Lake Plaza 2 Route 706 E
Montrose, PA 18801-0285

Mailing address

185 Fallbrook St
Carbondale, PA 18407-0514
Phone (570) 282-1732

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
I20100323000029 PA Practitioner - Clinical Social Worker 1850426388 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrative Counseling Services, PCGroup PAC ID 5698046357, 25 clinicians

Practice addresses (Care Compare)

52 Summit St
New Milford, PA 18834-2313
Phone (570) 465-2080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Counseling Services, PC CurrentSince Apr 1, 2018 Accepting new patients
Empowered Resilience PastSince Apr 1, 2018 Accepting new patients
Tri County Human Services Center Inc Past Accepting new patients

Locations

52 Summit St
New Milford, PA 18834
Phone (570) 465-2080

300 Mulberry St
Ste 201
Scranton, PA 18503
Phone (570) 955-5479

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270080000000",
    "number": "1285698340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 FALLBROOK ST",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184070514",
            "telephone_number": "570-282-1732",
            "fax_number": "570-282-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAKE PLAZA 2 ROUTE 706 E",
            "city": "MONTROSE",
            "state": "PA",
            "postal_code": "188010285",
            "telephone_number": "570-278-3393",
            "fax_number": "570-278-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEERAN",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2010-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, PA

Sources for this page

Verify at the official NPI Registry.