Individual provider Active NPI

Pamela Rose Cosper, LCSW

  • Clinical Social Worker
  • Bloomsburg, PA
National Provider Identifier
1740669183
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW018964 Issued in PA
Practice address
16 Sherwood Drive
Suite C
Bloomsburg, PA 17815-3086
Phone
(570) 204-4028
Fax
(570) 445-2214
NPI assigned
May 19, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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 CW018964 PA Primary

Addresses

Primary practice location

16 Sherwood Drive
Suite C
Bloomsburg, PA 17815-3086

Mailing address

16 Sherwood Dr Ste C
Bloomsburg, PA 17815-3086
Phone (570) 204-4028

Other identifiers 2

IdentifierTypeStateIssuer
1035723800001MedicaidPA
0019468810006MedicaidPA

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
I20180928002116 PA Practitioner - Clinical Social Worker 9638429574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

16 Sherwood Dr
Suite C
Bloomsburg, PA 17815-3086
Phone (570) 204-4028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW018964PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Counseling Center, LLC Clinical CurrentSince Aug 14, 2018 Accepting new patients

Locations

16 Sherwood Dr
Ste C
Bloomsburg, PA 17815
Phone (570) 204-4028

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": "1431993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1740669183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SHERWOOD DR STE C",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178153086",
            "telephone_number": "570-204-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SHERWOOD DRIVE",
            "address_2": "SUITE C",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178153086",
            "telephone_number": "570-204-4028",
            "fax_number": "570-445-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSPER",
        "first_name": "PAMELA",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-19",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035723800001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019468810006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.