Individual provider Active NPI

Casey Kathleen Hubbell, LSW

  • Social Worker
  • Erie, PA
National Provider Identifier
1821633538
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW136731 Issued in PA
Practice address
1330 W 26TH St
Erie, PA 16508-1402
Phone
(814) 459-9300
Fax
(814) 454-7780
NPI assigned
Nov 18, 2019
Last updated
May 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW136731 PA Primary

Addresses

Primary practice location

1330 W 26TH St
Erie, PA 16508-1402

Mailing address

1330 W 26TH St
Erie, PA 16508-1402
Phone (814) 459-9300

Other practice location 1

1125 6th St SE
Willmar, MN 56201-4675
Phone (320) 235-4613

Other names 1

  • Mrs. Casey Kathleen Roberts Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address SafeHarbor@upmcdirect.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20220524001658 MN Practitioner - Clinical Social Worker 2163809591 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Woodland CentersGroup PAC ID 7416860457, 39 clinicians

Practice addresses (Care Compare)

1125 SE 6TH St
Willmar, MN 56201-4675
Phone (320) 235-4613

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW136731PAMDSocial Worker
30862MNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Note to Self Therapy and Wellness LLC Current Accepting new patients
Woodland Centers CurrentSince May 12, 2022 Accepting new patients

Locations

1125 6th St SE
Willmar, MN 56201
Phone (320) 231-9148

3910 Caughey Rd
Ste 200
Erie, PA 16506
Phone (814) 464-5895

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1821633538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300",
            "fax_number": "814-454-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300",
            "fax_number": "814-454-7780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 6th St SE",
            "address_purpose": "LOCATION",
            "city": "Willmar",
            "state": "MN",
            "postal_code": "562014675",
            "country_code": "US",
            "telephone_number": "320-235-4613",
            "fax_number": "855-625-7406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUBBELL",
        "first_name": "CASEY",
        "middle_name": "KATHLEEN",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW136731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "SafeHarbor@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1330 W 26th St",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165081402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "ROBERTS",
            "middle_name": "KATHLEEN",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.