Individual provider Active NPI

Elizabeth (Betsy) M McConnell, MSW,LICSW,BCD

  • Clinical Social Worker
  • Pittsburgh, PA
National Provider Identifier
1891728242
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017609 Issued in PA
Practice address
5750 Baum Blvd
Suite 309
Pittsburgh, PA 15206
Phone
(412) 362-3600
NPI assigned
Jul 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 000113075 MA
Clinical Social Worker 1041C0700X CW017609 PA Primary

Addresses

Primary practice location

5750 Baum Blvd
Suite 309
Pittsburgh, PA 15206

Mailing address

5750 Baum Blvd
Suite 309
Pittsburgh, PA 15206-3793
Phone (412) 871-3438

Other identifiers 3

IdentifierTypeStateIssuer
000113075OtherMALICENSE NUMBER LICSW
CW017609OtherPAPA LICENSE IN CLINICAL SOCIAL SOCIAL WORK
PO8562OtherMABLUE CROSS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
000113075MAMDClinical Social Worker
CW017609PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1891728242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 BAUM BLVD",
            "address_2": "SUITE 309",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063793",
            "telephone_number": "412-871-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 BAUM BLVD",
            "address_2": "SUITE 309",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15206",
            "telephone_number": "412-362-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "ELIZABETH (BETSY)",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MSW,LICSW,BCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "000113075",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER LICSW",
            "identifier": "000113075",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE IN CLINICAL SOCIAL SOCIAL WORK",
            "identifier": "CW017609",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PO8562",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.