Individual provider Active NPI

Renee Cavallaro, MSS, LCSW, CCDP-D

  • Clinical Social Worker
  • Jamison, PA
National Provider Identifier
1548617632
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW014698 Issued in PA
Practice address
1753 Kendarbren Dr
Suite 612
Jamison, PA 18929-1043
Phone
(215) 792-7305
NPI assigned
May 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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 CW014698 PA Primary

Addresses

Primary practice location

1753 Kendarbren Dr
Suite 612
Jamison, PA 18929-1043

Mailing address

1753 Kendarbren Dr
Suite 612
Jamison, PA 18929-1043
Phone (215) 792-7305

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CW014698PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Avenues Recovery Center of Bucks Past Accepting new patients

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": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1548617632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 KENDARBREN DR",
            "address_2": "SUITE 612",
            "city": "JAMISON",
            "state": "PA",
            "postal_code": "189291043",
            "telephone_number": "215-792-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 KENDARBREN DR",
            "address_2": "SUITE 612",
            "city": "JAMISON",
            "state": "PA",
            "postal_code": "189291043",
            "telephone_number": "215-792-7305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVALLARO",
        "first_name": "RENEE",
        "credential": "MSS, LCSW, CCDP-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamison, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.