Individual provider Active NPI

Charlene M Peachey, MSW, LCSW

  • Clinical Social Worker
  • Lebanon, PA
National Provider Identifier
1750442877
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW013783 Issued in PA
Practice address
283 S Butler Rd
Lebanon, PA 17042-8939
Phone
(800) 932-0359
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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 CW013783 PA Primary

Addresses

Primary practice location

283 S Butler Rd
Lebanon, PA 17042-8939

Mailing address

601 Memory LN
York, PA 17402-2231
Phone (717) 851-1405

Other practice location 1

239 South Butler Road
Psychiatric Outpatient
Lebanon, PA 17042
Phone (717) 273-8871

Other identifiers 3

IdentifierTypeStateIssuer
103744270MedicaidPA
CW013783OtherPASTATE LICENSE
11657369OtherCAQH

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
I20060123000098 PA Practitioner - Clinical Social Worker 6103840764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PhilhavenGroup PAC ID 8729991419, 93 clinicians

Practice addresses (Care Compare)

239 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 270-2422

2501 Oregon Pike
Lancaster, PA 17601-4890
Phone (717) 735-1954

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 270-2422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW013783PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Philhaven CurrentSince Jan 1, 2005 Accepting new patients
Philhaven Current Accepting new patients
Wellspan Medical Group PastSince Oct 1, 2022 Accepting new patients

Locations

785 5th Ave
Ste 3
Chambersburg, PA 17201

2501 Oregon Pike
Ste 113
Lancaster, PA 17601
Phone (717) 735-1954

964 Isabel Dr
Lebanon, PA 17042
Phone (717) 274-9777

204 Hathaway Park
Lebanon, PA 17042
Phone (717) 274-9777

283 S Butler Rd
Lebanon, PA 17042

283 Butler Rd
Mount Gretna, PA 17064
Phone (800) 932-0359

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

Organizations & group practices 3

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1750442877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 MEMORY LN",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174022231",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 S BUTLER RD",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170428939",
            "telephone_number": "800-932-0359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "239 South Butler Road",
            "address_2": "Psychiatric Outpatient",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "17042",
            "country_code": "US",
            "telephone_number": "717-273-8871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEACHEY",
        "first_name": "CHARLENE",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW013783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103744270",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CW013783",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11657369",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, PA

Sources for this page

Verify at the official NPI Registry.