Individual provider Active NPI

Rachel Leeann Niedrist, MSS, LCSW

  • Clinical Social Worker
  • Souderton, PA
National Provider Identifier
1366143646
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW022171 Issued in PA
Practice address
121 N Main St Ste 310
Souderton, PA 18964-1799
Phone
(267) 354-0113
NPI assigned
Mar 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 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 CW022171 PA Primary

Addresses

Primary practice location

121 N Main St Ste 310
Souderton, PA 18964-1799

Mailing address

121 N Main St Ste 310
Souderton, PA 18964-1799
Phone (267) 354-0113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CW022171PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Wisteria Counseling Clinical CurrentSince Mar 19, 2023 Accepting new patients

Locations

121 N Main St
Ste 310
Souderton, PA 18964
Phone (267) 217-3649

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": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1366143646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 N MAIN ST STE 310",
            "city": "SOUDERTON",
            "state": "PA",
            "postal_code": "189641799",
            "telephone_number": "267-354-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 N MAIN ST STE 310",
            "city": "SOUDERTON",
            "state": "PA",
            "postal_code": "189641799",
            "telephone_number": "267-354-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEDRIST",
        "first_name": "RACHEL",
        "middle_name": "LEEANN",
        "name_prefix": "Mrs.",
        "credential": "MSS, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Souderton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.