Carol Betton Bembenic, LSW MSW M ED
Individual provider Active NPI Social Worker · Brockway, PA
NPI 1750626263 · NPPES record last updated Dec 10, 2012
Key facts
- NPI
- 1750626263
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- SW130006 (PA)
- Practice address
- 909 9TH Ave
Brockway, PA 15824-1605 - Phone
- (814) 265-0985
- NPI assigned
- Dec 10, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dickinson Center, Inc
Practice addresses (Care Compare)
43 Servidea Dr
Ridgway, PA 15853-6333
Phone (814) 766-2145
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151001001865 | PA | Practitioner - Clinical Social Worker | 6305154949 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW130006 | PA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dickinson Center, Inc | Current |
Accepting new patients |
Locations
1001 E 2nd St
Coudersport, PA 16915
Phone (814) 274-7407
43 Servidea Dr
Ridgway, PA 15853
Phone (814) 776-0225
808 S Michael St
Saint Marys, PA 15857
Phone (814) 834-9722
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | SW130006 | PA | Yes |
Addresses
Primary practice location
909 9TH Ave
Brockway, PA 15824-1605
Mailing address
909 9TH Ave
Brockway, PA 15824-1605
Phone (814) 265-0985
Other providers in Brockway, PA
- Susan Jean Baka
- Wendy Susan Bingler
- Nancy London Bittner
- Jacient D. Bray
- Jack Britten
- Brockway Area Ambulance Service, Inc
All providers in Brockway, PA · Social Worker in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.