Organization Active NPI

C&D Senior Innovations LLC

  • Clinical Social Worker
  • Quakertown, PA
National Provider Identifier
1629519087
Registry record updated Mar 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017317 Issued in PA
Legal business name
C&D SENIOR INNOVATIONS LLC
Practice address
165 California Rd
#11
Quakertown, PA 18951-6559
Phone
(336) 575-0410
NPI assigned
Mar 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2017

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

Authorized official

Name
Cathryn C Stettler, LCSW
Title
Chief Executive Officer
Phone
(336) 575-0410

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X CW017317 PA Primary

Addresses

Primary practice location

165 California Rd
#11
Quakertown, PA 18951-6559

Mailing address

165 California Rd
#11
Quakertown, PA 18951-6559
Phone (336) 575-0410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170512000003 PA Part B Supplier - Clinic/Group Practice 7416234869 Receives reassigned benefits from 1 practitioner
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Locations

502 W 7th St
Erie, PA 16502
Phone (336) 575-0410

165 California Rd
Unit 11
Quakertown, PA 18951
Phone (336) 575-0410

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489708800000",
    "number": "1629519087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 CALIFORNIA RD",
            "address_2": "#11",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "189516559",
            "telephone_number": "336-575-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 CALIFORNIA RD",
            "address_2": "#11",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "189516559",
            "telephone_number": "336-575-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C&D SENIOR INNOVATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-03-17",
        "status": "A",
        "authorized_official_last_name": "STETTLER",
        "authorized_official_first_name": "CATHRYN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "336-575-0410",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quakertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.