Organization Active NPI

Taking Flight Developmental Center, LLC

  • Professional Counselor
  • State College, PA
National Provider Identifier
1023407673
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC008556 Issued in PA
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

Updated by the provider on Nov 14, 2018

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)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X PC008556 PA Primary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

Locations

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.

Verify at the official NPI Registry.