Individual provider Active NPI

Tammy Lee Rade, LCSW

  • Clinical Social Worker
  • Covington TWP, PA
National Provider Identifier
1407857899
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
254 Daleville Highway
Covington TWP, PA 18444-7831
Phone
(570) 904-7363
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 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 Primary

Addresses

Primary practice location

254 Daleville Highway
Covington TWP, PA 18444-7831

Mailing address

228 S Main Ave
Scranton, PA 18504
Phone (570) 904-7363

Other practice location 1

228 S Main Ave
Scranton, PA 18504
Phone (570) 904-7363

Other names 1

  • Ms. Tammy Lee Benjamin Former name

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
I20200114000041 PA Practitioner - Clinical Social Worker 2567897994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thaxton Holistic Wellness CenterGroup PAC ID 2769818418, 22 clinicians

Practice addresses (Care Compare)

228 S Main Ave
Scranton, PA 18504-2545
Phone (570) 904-7363

254 Daleville Hwy
Covington Township, PA 18444-7951
Phone (570) 904-7363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thaxton Holistic Wellness Center CurrentSince Jan 1, 2020 Accepting new patients
Pennsylvania Counseling Services Inc. PastSince Jun 14, 2007 Accepting new patients

Locations

2324 Boulevard Ave
Scranton, PA 18509
Phone (570) 343-2244

228 S Main Ave
Scranton, PA 18504
Phone (570) 468-5191

Organizations & group practices 2

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1407857899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 S MAIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "18504",
            "telephone_number": "570-904-7363",
            "fax_number": "570-348-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 DALEVILLE HIGHWAY",
            "city": "COVINGTON TWP",
            "state": "PA",
            "postal_code": "184447831",
            "telephone_number": "570-904-7363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 S Main Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "18504",
            "country_code": "US",
            "telephone_number": "570-904-7363",
            "fax_number": "570-348-4079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RADE",
        "first_name": "TAMMY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMY",
            "last_name": "BENJAMIN",
            "middle_name": "LEE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Covington TWP, PA

Sources for this page

Verify at the official NPI Registry.