Individual provider Active NPI

Talayna Bowersox

  • Social Worker
  • Harrisburg, PA
National Provider Identifier
1629657036
Registry record updated Apr 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW127166 Issued in PA
Practice address
4309 Linglestown Rd Ste 214
Harrisburg, PA 17112-8607
Phone
(717) 412-4908
NPI assigned
Apr 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW127166 PA Primary

Addresses

Primary practice location

4309 Linglestown Rd Ste 214
Harrisburg, PA 17112-8607

Mailing address

319 Peffer St
Harrisburg, PA 17102-1834

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
I20230627002084 PA Practitioner - Clinical Social Worker 4183082985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrative Counseling Services, PCGroup PAC ID 5698046357, 25 clinicians

Practice addresses (Care Compare)

300 Mulberry St
Suite 201
Scranton, PA 18503-1233
Phone (570) 955-5479

4309 Linglestown Rd
Suite 214
Harrisburg, PA 17112-8607
Phone (717) 412-4908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW127166PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Counseling Services, PC CurrentSince Jun 1, 2023 Accepting new patients

Locations

4309 Linglestown Rd
Ste 214
Harrisburg, PA 17112
Phone (717) 412-4908

300 Mulberry St
Ste 201
Scranton, PA 18503
Phone (570) 955-5479

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.

NPI Registry JSON

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

{
    "created_epoch": "1617494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617494400000",
    "number": "1629657036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 PEFFER ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171021834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 LINGLESTOWN RD STE 214",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171128607",
            "telephone_number": "717-412-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOWERSOX",
        "first_name": "TALAYNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-04",
        "last_updated": "2021-04-04",
        "certification_date": "2021-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW127166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.