Individual provider Active NPI

Beverly Dochstader, LCSW

  • Clinical Social Worker
  • Mansfield, PA
National Provider Identifier
1497074348
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW014589 Issued in 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
Last updated
May 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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 CW014589 PA Primary

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

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
I20130215000311 PA Practitioner - Clinical Social Worker 1355595570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

63 3Rd St
Suite 103
Mansfield, PA 16933-1262
Phone (570) 622-7600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Concern-Professional Services for Children, Youth & Families CurrentSince Dec 12, 2012 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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274140800000",
    "number": "1497074348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ST. JAMES & THIRD STREET",
            "address_2": "SUITE 103S",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "16933",
            "telephone_number": "570-662-7600",
            "fax_number": "570-662-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST. JAMES & THIRD STREET",
            "address_2": "SUITE 103S",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "16933",
            "telephone_number": "570-662-7600",
            "fax_number": "570-662-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCHSTADER",
        "first_name": "BEVERLY",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-18",
        "last_updated": "2010-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, PA

Sources for this page

Verify at the official NPI Registry.