Individual provider Active NPI

Pamela M Woodson, LCSW

  • Clinical Social Worker
  • Dardanelle, AR
National Provider Identifier
1295861649
Registry record updated May 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
116 S Front St
Dardanelle, AR 72834-4028
Phone
(479) 453-0303
Fax
(479) 477-5509
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2022

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 Primary

Addresses

Primary practice location

116 S Front St
Dardanelle, AR 72834-4028

Mailing address

116 S Front St
Dardanelle, AR 72834-4028
Phone (479) 453-0303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20140421000269 AR Practitioner - Clinical Social Worker 9436381779 Reassigns benefits to 1 organization
Practice locations: Russellville, AR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

915 W Main St
Russellville, AR 72801-3508
Phone (479) 453-0303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pam Woodson Professional Counseling, Inc. Clinical CurrentSince Jun 16, 2016 Accepting new patients

Locations

116 S Front St
Ste D
Dardanelle, AR 72834

116 S Front St
Dardanelle, AR 72834
Phone (479) 229-3150

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653264000000",
    "number": "1295861649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S FRONT ST",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728344028",
            "telephone_number": "479-453-0303",
            "fax_number": "479-477-5509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S FRONT ST",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728344028",
            "telephone_number": "479-453-0303",
            "fax_number": "479-477-5509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODSON",
        "first_name": "PAMELA",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2022-05-23",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dardanelle, AR

Sources for this page

Verify at the official NPI Registry.