Individual provider Active NPI

Kathleen A Becerril

  • Social Worker
  • Plymouth Meeting, PA
National Provider Identifier
1477815603
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
2250 Hickory Rd
Plymouth Meeting, PA 19462-1047
Phone
(610) 834-1122
NPI assigned
Jun 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NJ Primary

Addresses

Primary practice location

2250 Hickory Rd
Plymouth Meeting, PA 19462-1047

Mailing address

2250 Hickory Rd
Plymouth Meeting, PA 19462-1047

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
I20230504002235 PA Practitioner - Clinical Social Worker 5799108122 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindy Staum LCSW PAGroup PAC ID 5890952998, 16 clinicians

Practice addresses (Care Compare)

101 Plaza Dr
Downingtown, PA 19335-5301
Phone (484) 364-3294

975 Wind Song Rd
West Chester, PA 19382-2056
Phone (732) 580-8383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindy Staum, LCSW, P.a CurrentSince Nov 19, 2022 Accepting new patients

Locations

5421 N University Dr
Ste 102
Coral Springs, FL 33067
Phone (732) 580-8383

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1477815603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 HICKORY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 HICKORY RD",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621047",
            "telephone_number": "610-834-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRIL",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-13",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.