Active NPI
Johnna Fratarcangelo, LCSW
- Clinical Social Worker
- Peckville, PA
National Provider Identifier
1629462775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW020452
- Practice address
- 1418 Main St Ste 207
Peckville, PA 18452-2050 - Phone
- (570) 277-1123
- NPI assigned
- Mar 26, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW131497 | PA | |
| Clinical Social Worker | 1041C0700X | CW020452 | PA | Primary |
Addresses
Primary practice location
1418 Main St Ste 207
Peckville, PA 18452-2050
Mailing address
1418 Main St Ste 207
Peckville, PA 18452-2050
Phone (570) 277-1123
Other practice location 1
30-32 N Main St
Carbondale, PA 18407-2304
Phone (570) 282-1732 ext. 223
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW131497 | PA | MD | Social Worker |
| CW020452 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Electric City Counseling | Clinical | Current | Accepting new patients |
Locations
1418 Main St
Ste 207
Peckville, PA 18452
Phone (570) 277-1123
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.
-
- Clinical Social Worker
- Peckville, PA
- NPI 1982250122
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613088000000",
"number": "1629462775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1418 MAIN ST STE 207",
"city": "PECKVILLE",
"state": "PA",
"postal_code": "184522050",
"telephone_number": "570-277-1123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1418 MAIN ST STE 207",
"city": "PECKVILLE",
"state": "PA",
"postal_code": "184522050",
"telephone_number": "570-277-1123"
}
],
"practiceLocations": [
{
"address_1": "30-32 N Main St",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "PA",
"postal_code": "184072304",
"country_code": "US",
"telephone_number": "570-282-1732 x223",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FRATARCANGELO",
"first_name": "JOHNNA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-26",
"last_updated": "2021-02-12",
"certification_date": "2021-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "PA",
"license": "SW131497",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW020452",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Peckville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.