Individual provider Active NPI

Denise Marie Mengak, LCSW

  • Clinical Social Worker
  • Wilkes Barre, PA
National Provider Identifier
1639132467
Registry record updated Jan 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW012764 Issued in PA
Practice address
33 E Northampton St
Wilkes Barre, PA 18701-2406
Phone
(570) 822-7118
Fax
(570) 829-7781
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2017

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 CW012764 PA Primary

Addresses

Primary practice location

33 E Northampton St
Wilkes Barre, PA 18701-2406

Mailing address

33 E Northampton St
Wilkes Barre, PA 18701-2406
Phone (570) 822-7118

Other identifiers 2

IdentifierTypeStateIssuer
4610572OtherPAAETNA
2101526OtherPACIGNA BEHAVIORAL HEALTH

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
I20120322000415 PA Practitioner - Clinical Social Worker 2062672413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Safe Pathways Counseling IncGroup PAC ID 4981041134, 2 clinicians

Practice addresses (Care Compare)

1172 Twin Stacks Dr
Dallas, PA 18612-8505
Phone (570) 674-1505

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Pathways Counseling Inc CurrentSince Feb 21, 2024 Accepting new patients

Locations

1172 Twin Stacks Dr
Dallas, PA 18612
Phone (570) 674-1505

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1639132467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 E NORTHAMPTON ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187012406",
            "telephone_number": "570-822-7118",
            "fax_number": "570-829-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 E NORTHAMPTON ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187012406",
            "telephone_number": "570-822-7118",
            "fax_number": "570-829-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENGAK",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4610572",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2101526",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.