Individual provider Active NPI

Annemarie Rich, LCSW

  • Clinical Social Worker
  • Smethport, PA
National Provider Identifier
1285957340
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017113 Issued in PA
Practice address
203 W Main St
Smethport, PA 16749-1259
Phone
(814) 887-2350
Fax
(814) 887-2084
NPI assigned
Mar 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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 CW017113 PA Primary

Addresses

Primary practice location

203 W Main St
Smethport, PA 16749-1259

Mailing address

PO Box 332
Smethport, PA 16749-0332
Phone (814) 887-2350

Other identifiers 1

IdentifierTypeStateIssuer
1029234630001MedicaidPA

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
I20111213000568 PA Practitioner - Clinical Social Worker 8426223876 Practice locations: Bradford, PA; Smethport, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

203 W Main St
Smethport, PA 16749-1259
Phone (814) 887-2350

80 E Corydon St
Bradford, PA 16701-6520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW017113PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Annemarie Rich, LCSW Counseling Services Clinical CurrentSince Jun 5, 2022 Accepting new patients

Locations

203 W Main St
Smethport, PA 16749
Phone (814) 887-2350

Organizations & group practices 1

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": "1267574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692316800000",
    "number": "1285957340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 332",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167490332",
            "telephone_number": "814-887-2350",
            "fax_number": "814-887-2084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W MAIN ST",
            "city": "SMETHPORT",
            "state": "PA",
            "postal_code": "167491259",
            "telephone_number": "814-887-2350",
            "fax_number": "814-887-2084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICH",
        "first_name": "ANNEMARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-03",
        "last_updated": "2023-08-18",
        "certification_date": "2022-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029234630001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smethport, PA

Sources for this page

Verify at the official NPI Registry.