Individual provider Active NPI

Raquel Panitz, LICSW

  • Clinical Social Worker
  • Easthampton, MA
National Provider Identifier
1992357545
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
125102 Issued in MA
Practice address
2 Mechanic St
Easthampton, MA 01027-1562
Phone
(413) 540-1197
NPI assigned
Jul 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 000224931 MA
Clinical Social Worker 1041C0700X 125102 MA Primary

Addresses

Primary practice location

2 Mechanic St
Easthampton, MA 01027-1562

Mailing address

PO Box 791
Holyoke, MA 01041-0791

Other identifiers 2

IdentifierTypeStateIssuer
Y10058MedicaidMA
110027820AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221122002753 MA Practitioner - Clinical Social Worker 3375911340 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000224931MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Counseling Center, Inc Social Worker CurrentSince Oct 8, 2022 Accepting new patients

Locations

303 Beech St
Holyoke, MA 01040
Phone (413) 540-1155

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.

NPI Registry JSON

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

{
    "created_epoch": "1563062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1992357545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 791",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010410791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MECHANIC ST",
            "city": "EASTHAMPTON",
            "state": "MA",
            "postal_code": "010271562",
            "telephone_number": "413-540-1197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANITZ",
        "first_name": "RAQUEL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-14",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MA",
            "license": "000224931",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "125102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Y10058",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110027820A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easthampton, MA

Sources for this page

Verify at the official NPI Registry.