Active NPI
Taking Flight Developmental Center, LLC
- Professional Counselor
- State College, PA
National Provider Identifier
1023407673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC008556
- Legal business name
- TAKING FLIGHT DEVELOPMENTAL CENTER, LLC
- Practice address
- 1981 Cato Ave
Suite 2
State College, PA 16801-2754 - Phone
- (814) 954-4187
- Fax
- (814) 954-4197
- NPI assigned
- Jan 21, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alisha Munda
- Title
- Business Manager
- Phone
- (814) 954-4187
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC008556 | PA | Primary |
| Psychologist | 103T00000X | PS-016201 | PA |
Addresses
Primary practice location
1981 Cato Ave
Suite 2
State College, PA 16801-2754
Mailing address
301 S Allen St Ste 106
State College, PA 16801-4862
Phone (814) 954-4187
National Provider Directory
National Provider DirectoryLocations
301 S Allen St
Ste 106
State College, PA 16801
1981 Cato Ave
#2
State College, PA 16801
Phone (814) 954-4187
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1542153600000",
"number": "1023407673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 S ALLEN ST STE 106",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168014862",
"telephone_number": "814-954-4187",
"fax_number": "814-954-4197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1981 CATO AVE",
"address_2": "SUITE 2",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168012754",
"telephone_number": "814-954-4187",
"fax_number": "814-954-4197"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TAKING FLIGHT DEVELOPMENTAL CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-01-21",
"last_updated": "2018-11-14",
"status": "A",
"authorized_official_last_name": "MUNDA",
"authorized_official_first_name": "ALISHA",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "814-954-4187"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC008556",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist",
"state": "PA",
"license": "PS-016201",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.