Individual provider Active NPI

Karen L Fetrow, LSW

  • Clinical Social Worker
  • Harrisburg, PA
National Provider Identifier
1790396638
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW136675 Issued in PA
Practice address
900 N 6TH St
Harrisburg, PA 17102-1703
Phone
(717) 233-4027
Fax
(717) 233-4047
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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 SW136675 PA Primary

Addresses

Primary practice location

900 N 6TH St
Harrisburg, PA 17102-1703

Mailing address

401 N Prince St
Lancaster, PA 17603-3009
Phone (717) 560-7917

Other names 1

  • Karen L Eby Former name

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
I20240618003527 PA Practitioner - Clinical Social Worker 5496298465 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

410 N Prince St
Lancaster, PA 17603-3010
Phone (717) 560-7917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW136675PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
T.W. Ponessa & Associates Counseling Services, Inc. CurrentSince May 4, 2024 Accepting new patients
T. W. Ponessa and Associates Counseling Past Accepting new patients

Locations

900 N 6th St
Harrisburg, PA 17102
Phone (717) 233-4027

410 N Prince St
Lancaster, PA 17603

15 S 9th St
Lebanon, PA 17042
Phone (717) 273-5992

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.

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1790396638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N PRINCE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033009",
            "telephone_number": "717-560-7917",
            "fax_number": "717-560-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N 6TH ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171021703",
            "telephone_number": "717-233-4027",
            "fax_number": "717-233-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETROW",
        "first_name": "KAREN",
        "middle_name": "L",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW136675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAREN",
            "last_name": "EBY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.