Individual provider Active NPI

Pamala Hedglin, MSW

  • Clinical Social Worker
  • Randle, WA
National Provider Identifier
1669861308
Registry record updated Apr 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW60816150 Issued in WA
Practice address
108 Kindle Road
Randle, WA 98377
Phone
(360) 497-3333
NPI assigned
Jan 19, 2015
Last updated
Apr 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Clinical Social Worker 1041C0700X LW60816150 WA Primary

Addresses

Primary practice location

108 Kindle Road
Randle, WA 98377

Mailing address

945 11TH Ave
Ste B
Longview, WA 98632-2555
Phone (360) 496-5112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20190510000827 WA Practitioner - Clinical Social Worker 3375886526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Group practices
Northwest Psychological Resources LLCGroup PAC ID 0244122745, 12 clinicians

Practice addresses (Care Compare)

945 11TH Ave
Suite B
Longview, WA 98632-2555
Phone (360) 414-8600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Psychological Resources LLC Counselor CurrentSince Mar 5, 2019 Accepting new patients

Locations

945 11th Ave
Ste B
Longview, WA 98632
Phone (360) 414-8600

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1421625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554336000000",
    "number": "1669861308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 11TH AVE",
            "address_2": "STE B",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322555",
            "telephone_number": "360-496-5112",
            "fax_number": "360-414-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 KINDLE ROAD",
            "city": "RANDLE",
            "state": "WA",
            "postal_code": "98377",
            "telephone_number": "360-497-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDGLIN",
        "first_name": "PAMALA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-19",
        "last_updated": "2019-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60816150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randle, WA

Sources for this page

Verify at the official NPI Registry.