Beverly Dochstader, LCSW
Individual provider Active NPI Clinical Social Worker · Mansfield, PA
NPI 1497074348 · NPPES record last updated May 18, 2010
Key facts
- NPI
- 1497074348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CW014589 (PA)
- Practice address
- St. James & Third Street
Suite 103S
Mansfield, PA 16933 - Phone
- (570) 662-7600
- Fax
- (570) 662-7726
- NPI assigned
- May 18, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Concern-Professional Services for Children, Youth and Families
Practice addresses (Care Compare)
63 3Rd St
Suite 103
Mansfield, PA 16933-1262
Phone (570) 622-7600
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130215000311 | PA | Practitioner - Clinical Social Worker | 1355595570 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW014589 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Concern-Professional Services for Children, Youth & Families | Current | Accepting new patients | |
| Concern-Professional Services for Children, Youth & Families | Current |
Accepting new patients | |
| Concern-Professional Services for Children, Youth & Families | Past | Accepting new patients |
Locations
1 W Main St
Fleetwood, PA 19522
63 3rd St
Ste 103
Mansfield, PA 16933
Phone (570) 622-7600
62 Plaza Ln
Wellsboro, PA 16901
Phone (570) 724-7142
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW014589 | PA | Yes |
Addresses
Primary practice location
St. James & Third Street
Suite 103S
Mansfield, PA 16933
Mailing address
St. James & Third Street
Suite 103S
Mansfield, PA 16933
Phone (570) 662-7600
Other providers in Mansfield, PA
- Concern-Professional Services for Children, Youth & Families
- John R. Coole
- Maria Luisa Cruz
- Stacy D Dean
- Theresa Dolores Delmotte
- Rosalia R Dominguez
- George Reyes Dy
- Elite Therapy PC
- Family Recovery, LLC
- Amy Lynn Farrer
All providers in Mansfield, PA · Clinical Social Worker in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.