Elianna Altagracia Aguirre

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bangor, PA

NPI 1013747690 · NPPES record last updated Jan 6, 2026

Key facts

NPI
1013747690
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
109 Broadway
Bangor, PA 18013-2505
Phone
(610) 599-7700
NPI assigned
Aug 7, 2024
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
APC002023PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Revolution, Inc. Past
since Aug 11, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes
Mental Health Counselor 101YM0800X APC002023 PA

Addresses

Primary practice location

109 Broadway
Bangor, PA 18013-2505

Mailing address

92A Garibaldi Ave
Roseto, PA 18013-1328
Phone (201) 253-5116

Other practice location 1

221 W High St Ste 300
Bellefonte, PA 16823-1351
Phone (814) 380-9442

Other providers in Bangor, PA

All providers in Bangor, PA · Addiction (Substance Use Disorder) Counselor in Pennsylvania

Sources for this page

Verify at the official NPI Registry.