Provider Demographics
NPI:1144511783
Name:CLINICAL SOCIAL WORKER ASSOCIATES, INC.
Entity type:Organization
Organization Name:CLINICAL SOCIAL WORKER ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:570-640-3744
Mailing Address - Street 1:899 WYNONAH DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:PA
Mailing Address - Zip Code:17922-9214
Mailing Address - Country:US
Mailing Address - Phone:570-640-3744
Mailing Address - Fax:
Practice Address - Street 1:396 S. CENTRE STREET
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3655
Practice Address - Country:US
Practice Address - Phone:570-640-3744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-01
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW013192L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10129699500Medicaid
PA045227Medicare PIN