Active NPI
Corey Larue
- Mental Health Counselor
- Johnstown, PA
National Provider Identifier
1013426253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 119 Walnut St
Johnstown, PA 15901-1625 - Phone
- (814) 534-0745
- NPI assigned
- Sep 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
119 Walnut St
Johnstown, PA 15901-1625
Mailing address
119 Walnut St
Johnstown, PA 15901-1625
Phone (814) 534-0745
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240129001518 | PA | Practitioner - Mental Health Counselor | 3476906272 | Reassigns benefits to 1 organization |
| I20250103001790 | OR | Practitioner - Mental Health Counselor | 3476906272 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifeline Medical Center | Mental Health | Current | Accepting new patients |
Locations
1915 NE Stucki Ave
Ste 400
Hillsboro, OR 97006
Phone (844) 408-0014
1925 NE Stucki Ave
Ste 150
Hillsboro, OR 97006
500 Galleria Dr
Ste 164
Johnstown, PA 15904
620 Galleria Dr
Johnstown, PA 15904
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GGCGDD/Endpoint/GGCGDD
- https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4
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": "1505865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1013426253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 WALNUT ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159011625",
"telephone_number": "814-534-0745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 WALNUT ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159011625",
"telephone_number": "814-534-0745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARUE",
"first_name": "COREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Johnstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.