Bonnie Armentrout, LICW

Individual provider Active NPI Clinical Social Worker · Baker, WV

NPI 1922400274 · NPPES record last updated Sep 18, 2014

Key facts

NPI
1922400274
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
DP02943646 (WV)
Practice address
17978 Sr 55
Baker, WV 26801-0097
Phone
(304) 897-5915
Fax
(304) 897-6216
NPI assigned
Sep 18, 2014
Sex
Female
Sole proprietor
No

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CPT (10 clinicians)

Practice addresses (Care Compare)

249 Henderson Ave
Cumberland, MD 21502-1638
Phone (240) 362-7444

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20181129001899 MD Practitioner - Clinical Social Worker 8426374703 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DP02943646WVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CPT Current
since Oct 7, 2018
Accepting new patients

Locations

249 Henderson Ave
Cumberland, MD 21502
Phone (240) 362-7444

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X DP02943646 WV Yes

Addresses

Primary practice location

17978 Sr 55
Baker, WV 26801-0097

Mailing address

PO Box 97
Baker, WV 26801-0097
Phone (304) 897-5915

Other providers in Baker, WV

All providers in Baker, WV · Clinical Social Worker in West Virginia

Sources for this page

Verify at the official NPI Registry.