Eugena Patackas, MS LBS LPC NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

106 Colburn Ave
Clarks Summit, PA 18411-1569

Phone

(570) 687-7495

NPI assigned

Jul 3, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Gena Patackas Professional name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Gena Patackas LPC LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peckville, PA
  • NPI 1497590491
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1435881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446595200000",
    "number": "1003299397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 E PINE ST",
            "city": "OLYPHANT",
            "state": "PA",
            "postal_code": "184471934",
            "telephone_number": "570-687-7495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 COLBURN AVE",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184111569",
            "telephone_number": "570-687-7495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATACKAS",
        "first_name": "EUGENA",
        "credential": "MS LBS LPC NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-03",
        "last_updated": "2015-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENA",
            "last_name": "PATACKAS",
            "credential": "MS LBS LPC NCC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Christopher Oyede, MD
• PA Deptment of Public Welfare
• Anthony Joseph Pagnotti, ED.D.
• Samir Bipin Pancholy, M.D.
• Kristin Ann Paoli, DMD
• Michael A Patrician, DMD
• Pennsylvania CVS Pharmacy, L.L.C.
• Pennsylvania Department of Human Services
• William Peoples
• Allan F Perfilio, DC

• Counselor in Clarks Summit, PA
• Providers in Clarks Summit, PA by specialty
• Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.