Individual provider Active NPI

William Gerard Longacre Jr.

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1306612239
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW024217 Issued in PA
Practice address
500 S 47TH St Apt 302
Philadelphia, PA 19143-2161
Phone
(484) 888-3481
NPI assigned
Dec 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 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 CW024217 PA Primary

Addresses

Primary practice location

500 S 47TH St Apt 302
Philadelphia, PA 19143-2161

Mailing address

500 S 47TH St Apt 302
Philadelphia, PA 19143-2161
Phone (484) 888-3481

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
I20231216000116 PA Practitioner - Clinical Social Worker 1456700459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling and Wellness LLCGroup PAC ID 3577977362, 5 clinicians

Practice addresses (Care Compare)

Blue Bell, PA 19422
Phone (610) 864-5476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW024217PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling and Wellness LLC Clinical CurrentSince Dec 5, 2023 Accepting new patients

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": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1306612239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S 47TH ST APT 302",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191432161",
            "telephone_number": "484-888-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 47TH ST APT 302",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191432161",
            "telephone_number": "484-888-3481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGACRE",
        "first_name": "WILLIAM",
        "middle_name": "GERARD",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW024217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.