Active NPI
Pamela A Correll, LSW
- Clinical Social Worker
- Cedar Falls, IA
National Provider Identifier
1770528135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 618
- Practice address
- 2802 Orchard Dr
Cedar Falls, IA 50613-5898 - Phone
- (319) 268-9700
- Fax
- (319) 268-1934
- NPI assigned
- Jun 19, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 618 | IA | Primary |
Addresses
Primary practice location
2802 Orchard Dr
Cedar Falls, IA 50613-5898
Mailing address
2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 618 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Center, Inc. | Past | Accepting new patients | |
| Psychiatric Associates of Northeast Iowa PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Customized Equipment (DME)
- Evansdale, IA
- NPI 1851141980
-
- Marriage & Family Therapist
- Waterloo, IA
- NPI 1457428112
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1770528135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 KIMBALL AVE",
"address_2": "LL14",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025063",
"telephone_number": "319-272-1590",
"fax_number": "319-272-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2802 ORCHARD DR",
"city": "CEDAR FALLS",
"state": "IA",
"postal_code": "506135898",
"telephone_number": "319-268-9700",
"fax_number": "319-268-1934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORRELL",
"first_name": "PAMELA",
"middle_name": "A",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-19",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IA",
"license": "618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Falls, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.