Elizabeth T. Gotwals, MSW,LCSW,ACSW,QCSW
Individual provider Active NPI Social Worker · MC Connellsburg, PA
NPI 1619951183 · NPPES record last updated Aug 10, 2010
Key facts
- NPI
- 1619951183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- CW013617 (PA)
- Practice address
- 214 Peach Orchard Road
MC Connellsburg, PA 17233 - Phone
- (717) 485-6120
- Fax
- (717) 485-6106
- NPI assigned
- Nov 30, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Temple University School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
214 Peach Orchard Rd
MC Connellsburg, PA 17233-8559
Phone (717) 485-6120
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 |
|---|---|---|---|---|
| I20071018000038 | PA | Practitioner - Clinical Social Worker | 9830285121 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CWO13617 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fulton Behavioral Health Services PC | Social Worker | Current |
Accepting new patients |
| Antietam Neurology Center, PA | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CWO13617 | PA | |
| Social Worker | 104100000X | CW013617 | PA | Yes |
Addresses
Primary practice location
214 Peach Orchard Road
MC Connellsburg, PA 17233
Mailing address
214 Peach Orchard Road
MC Connellsburg, PA 17233
Phone (717) 485-6120
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018117730001 | Medicaid | PA | |
| 0018117730004 | Medicaid | PA |
Other providers in MC Connellsburg, PA
- Fulton County Partnership
- Fulton Diagnostic Radiology LLC
- Fulton Diagnostic Radiology, LLC
- Gaudenzia
- Erin Camille Glenn
- Cody Grace
- Great Cove Integrative Medicine LLC
- Gerald E Gronborg
- Lavan Harris
- Deann Laura Hawkins
All providers in MC Connellsburg, PA · 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 Aug 10, 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.