Individual provider Active NPI

Pamela Jean Tibbs, LCSW

  • Clinical Social Worker
  • Palmerton, PA
National Provider Identifier
1831478999
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW08143 Issued in PA
Practice address
3295 Forest Inn Rd Suite 3
Palmerton, PA 18071
Phone
(855) 826-8482
Fax
(855) 826-8482
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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 CW08143 PA Primary

Addresses

Primary practice location

3295 Forest Inn Rd Suite 3
Palmerton, PA 18071

Mailing address

3295 Forest Inn Rd Suite 3
Palmerton, PA 18071
Phone (855) 826-8482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150211000856 PA Practitioner - Clinical Social Worker 6406171636 Reassigns benefits to 2 organizations
I20251222003662 FL Practitioner - Clinical Social Worker 6406171636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW08143PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Vita Counseling Partners Clinical CurrentSince Oct 1, 2014 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Nov 1, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3295 Forest Inn Rd
Ste 3
Palmerton, PA 18071
Phone (610) 826-8482

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

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": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1831478999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3295 FOREST INN RD SUITE 3",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "18071",
            "telephone_number": "855-826-8482",
            "fax_number": "855-826-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3295 FOREST INN RD SUITE 3",
            "city": "PALMERTON",
            "state": "PA",
            "postal_code": "18071",
            "telephone_number": "855-826-8482",
            "fax_number": "855-826-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBS",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-08",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW08143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmerton, PA

Sources for this page

Verify at the official NPI Registry.