Blue Ridge Counseling Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

BLUE RIDGE COUNSELING SERVICES, LLC

Practice address

401 E Louther St Ste 204
Carlisle, PA 17013-2646

Phone

(717) 918-9961

Fax

(717) 918-9961

NPI assigned

Jan 13, 2022

Organization subpart

No

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

Authorized official

Name

Emily Fenner, LCSWNPI 1114686706

Title

Licensed Clinical Social Worker

Phone

(717) 918-9961

Specialties & licenses 1

Addresses

Other names 1

• Blue Ridge Counseling Services Former legal business name

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emily Carolyn Fenner, LCSW

  • Clinical Social Worker
  • Carlisle, PA
  • NPI 1114686706
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1841941671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E LOUTHER ST STE 204",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170132646",
            "telephone_number": "717-918-9961",
            "fax_number": "717-918-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E LOUTHER ST STE 204",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170132646",
            "telephone_number": "717-918-9961",
            "fax_number": "717-918-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIDGE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "FENNER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "717-918-9961",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Ridge Counseling Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Carlisle, PA
• Providers in Carlisle, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.