Individual provider Active NPI

Laura Alene McFetridge, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1619211315
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016265 Issued in PA
Practice address
100 W Lehigh Ave
Philadelphia, PA 19133-4039
Phone
(215) 203-3037
Fax
(215) 203-3078
NPI assigned
Nov 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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 CW016265 PA Primary

Addresses

Primary practice location

100 W Lehigh Ave
Philadelphia, PA 19133-4039

Mailing address

2840 W Dauphin St
Philadelphia, PA 19132-4627
Phone (215) 739-2075

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
I20121220000261 PA Practitioner - Clinical Social Worker 5597917534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Care Therapy of Pennsylvania PCGroup PAC ID 2264791268, 28 clinicians

Practice addresses (Care Compare)

Prospect Park, PA 19076
Phone (973) 264-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW016265PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Care Therapy of Pennsylvania, P.C. Clinical CurrentSince Oct 1, 2022 Accepting new patients
Family Services of Montgomery County PA Clinical CurrentSince Jun 1, 2021 Accepting new patients

Locations

2719 Hollywood Blvd
Hollywood, FL 33020
Phone (954) 354-2555

3125 Ridge Pike
Norristown, PA 19403
Phone (610) 230-2111

815 Chester Pike
Prospect Park, PA 19076
Phone (610) 586-6262

Organizations & group practices 2

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": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1619211315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 W DAUPHIN ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191324627",
            "telephone_number": "215-739-2075",
            "fax_number": "215-203-3078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W LEHIGH AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191334039",
            "telephone_number": "215-203-3037",
            "fax_number": "215-203-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCFETRIDGE",
        "first_name": "LAURA",
        "middle_name": "ALENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.