Active NPI
Wendy Ann Roth, LCSW
- Clinical Social Worker
- Jim Thorpe, PA
National Provider Identifier
1891741187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW013080
- Practice address
- 616 North St
Suite 304
Jim Thorpe, PA 18229-2125 - Phone
- (570) 325-2289
- NPI assigned
- May 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW013080 | PA | Primary |
Addresses
Primary practice location
616 North St
Suite 304
Jim Thorpe, PA 18229-2125
Mailing address
616 North St
Suite 304
Jim Thorpe, PA 18229-2125
Phone (570) 325-2289
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40046861 | Other | PA | CAPITALBLUECROSSSHIELD |
| 1738209 | Other | PA | HIGHMARK BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| CW013080 | PA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Guidance Program | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychiatry Physician
- Allentown, PA
- NPI 1730134156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891741187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 NORTH ST",
"address_2": "SUITE 304",
"city": "JIM THORPE",
"state": "PA",
"postal_code": "182292125",
"telephone_number": "570-325-2289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 NORTH ST",
"address_2": "SUITE 304",
"city": "JIM THORPE",
"state": "PA",
"postal_code": "182292125",
"telephone_number": "570-325-2289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROTH",
"first_name": "WENDY",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW013080",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITALBLUECROSSSHIELD",
"identifier": "40046861",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "1738209",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jim Thorpe, PA
- Pozitive Approach Counseling and Consultation Services LLC
- Kellie Price, LCSW
- Chandra S K Reddy, MD
- River Lotus Healing LLC (River Lotus Peer Based Recovery Support Services)
- Robert Roncek, DPT
- Taylor Saba
- Jason M Skrimcovsky, D.C.
- Deborah Ann Smith, MD
- St Luke's Physician Group, Inc (St. Luke's Jim Thorpe Primary Care)
- St. Luke's Hospital (St. Luke's Care Now - Jim Thorpe)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.