Individual provider Active NPI

Pamela Sue Mellott, LISW

  • Clinical Social Worker
  • Sioux City, IA
National Provider Identifier
1457597684
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06738 Issued in IA
Practice address
625 Court St
Sioux City, IA 51101-1919
Phone
(171) 225-2387
NPI assigned
Dec 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7995 NE
Clinical Social Worker 1041C0700X 06738 IA Primary
Mental Health Counselor 101YM0800X 6738 IA

Addresses

Primary practice location

625 Court St
Sioux City, IA 51101-1919

Mailing address

625 Court St
Sioux City, IA 51101-1919
Phone (171) 225-2387

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20111104000053 IA Practitioner - Clinical Social Worker 6901079128 Reassigns benefits to 1 organization

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
Group practices
Siouxland Mental Health Services Inc 30 clinicians

Practice addresses (Care Compare)

625 Court St
Sioux City, IA 51101-1919
Phone (712) 252-3871

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6738IAMDMental Health Counselor
06738IAMDClinical Social Worker
7995NEMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Siouxland Mental Health Services, Inc. Mental Health CurrentSince Aug 1, 2020 Accepting new patients

Locations

625 Court St
Sioux City, IA 51101
Phone (712) 252-3871

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": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1457597684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 COURT ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011919",
            "telephone_number": "171-225-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 COURT ST",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011919",
            "telephone_number": "171-225-2387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOTT",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-17",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "7995",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06738",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "6738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

Verify at the official NPI Registry.