Autumn Mangum

Primary specialty

Social WorkerTaxonomy code 104100000X

License

SW139708 Issued in PA

Practice address

3835 Chestnut St
Emmaus, PA 18049-1830

Phone

(484) 232-5288

NPI assigned

Jun 13, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA, NJ2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Valley Geropsych, LLCGroup PAC ID 2062659584, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Valley Geropsych, LLC

  • Geriatric Psychiatry Physician
  • Lehighton, PA
  • NPI 1588900815
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group of New Jersey PC

  • Mental Health Counselor
  • Hoboken, NJ
  • NPI 1841949328
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1686614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1609550276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 YEKER FARMS LN",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035956",
            "telephone_number": "484-353-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 CHESTNUT ST",
            "city": "EMMAUS",
            "state": "PA",
            "postal_code": "180491830",
            "telephone_number": "484-232-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "AUTUMN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-13",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW139708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Live Learn & Play, Inc.
• Tara Anne Lukitsch, MSOTR/L
• Kimberly J. Luybli, M.ED., NCC, LPC
• Namrhen R Lyngdoh, PA-C
• Kristin Lynn, MS/CCC-SLP
• Laura Mankos, PHARMD
• Jessica Gabrielle Mann, MS/CCC-SLP
• Suzanne Lynn Martin, PSY.D.
• Darin Paul Mazepa, D.C.
• Margaret Lynn McGill

• Social Worker in Emmaus, PA
• Providers in Emmaus, PA by specialty
• Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.