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CONSHOHOCKEN CENTER FOR EMOTIONAL HEALTH
NPI 1003363615
Social Worker - Clinical in Conshohocken, PA

Active since September 01, 2016
20 E 2ND AVE STE 100, CONSHOHOCKEN, PA 19428(610) 635-5677(610) 828-4910 Get Directions Write a Review

NPPES record last updated: November 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 26, 2019, Dec 29, 2016, Sep 17, 2016 and 1 more (4 updates tracked since 2016).

About Conshohocken Center For Emotional Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONSHOHOCKEN CENTER FOR EMOTIONAL HEALTH (NPI 1003363615) is a healthcare organization registered as a clinical in Conshohocken, Pennsylvania and active in the NPI registry since September 2016. The organization lists Carolyn M Fortenberry, Business Owner, as its authorized official.

NPPES Registry Identity

NPI1003363615
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameCONSHOHOCKEN CENTER FOR EMOTIONAL HEALTH
Location Address20 E 2ND AVE STE 100Conshohocken, PA 19428-1880
Mailing Address1101 New Dehaven StConshohocken, PA 19428-2742 · (610) 635-5677 · Fax (610) 828-4910
Phone(610) 635-5677
Fax(610) 828-4910
Organization SubpartNo
Authorized OfficialCarolyn M FortenberryBusiness Owner · (610) 635-5677
Enumeration DateSeptember 1, 2016
Last NPPES UpdateNovember 1, 20244 updates tracked since enumeration
NPPES CertifiedNovember 1, 2024
✔ NPI 1003363615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
20 E 2ND AVE STE 100, Conshohocken, PA 19428
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Conshohocken Center For Emotional Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Conshohocken Center For Emotional Health, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Carolyn Fortenberry, LCSW
Clinical Social Worker
NPI 1215286273
20 E 2ND AVE STE 100
Conshohocken, PA 19428
(610) 635-5677
✔ PECOS✔ Accepts MedicareSame address
Lauren Larason, LCSW
Clinical Social Worker
NPI 1093138844
20 E 2ND AVE STE 100
Conshohocken, PA 19428
(484) 534-9686
✔ PECOSSame address
Elizabeth Sysak, MS.ED
Mental Health Counselor
NPI 1902156979
333 N BRADDOCK AVE
Pittsburgh, PA 15208
(412) 864-5050
✔ PECOS✔ Accepts Medicare244 mi
Deborah Michelman, LAC
Mental Health Counselor
NPI 1750756029
20 E 2ND AVE STE 100
Conshohocken, PA 19428
(484) 534-9686
✔ PECOS✔ Accepts Medicare

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Conshohocken Center For Emotional Health's NPI number?

The NPI number for Conshohocken Center For Emotional Health is 1003363615. It was assigned to this organization in the NPPES registry on September 1, 2016.

Where is Conshohocken Center For Emotional Health located?

Conshohocken Center For Emotional Health is located at 20 E 2nd Ave Ste 100, Conshohocken, PA 19428. The listed phone number is (610) 635-5677.

What is Conshohocken Center For Emotional Health's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Conshohocken Center For Emotional Health enrolled in Medicare?

Yes. Conshohocken Center For Emotional Health is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Conshohocken Center For Emotional Health?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Conshohocken Center For Emotional Health, in Clinical Social Worker and Mental Health Counselor. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Conshohocken Center For Emotional Health was last updated on November 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.