Individual provider Active NPI

Yekaterina Tarkovsky

  • Professional Counselor
  • Hawley, PA
National Provider Identifier
1023661204
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC014498 Issued in PA
Practice address
106 Shook Rd Ste 209
Hawley, PA 18428-7059
Phone
(570) 977-1294
NPI assigned
Jul 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC014498 PA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

106 Shook Rd Ste 209
Hawley, PA 18428-7059

Mailing address

851 Commerce Blvd
Dickson City, PA 18519-1759
Phone (570) 489-5561

Other practice location 1

228 S Main Ave
Scranton, PA 18504-2545
Phone (570) 904-7363

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231130000025 PA Practitioner - Mental Health Counselor 9032567102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

106 Shook Rd
Suite 204
Hawley, PA 18428-7059
Phone (570) 977-1294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blissful Mind Counseling Services LLC Professional CurrentSince Nov 13, 2023 Accepting new patients
Aaron Center, Inc. PastSince Sep 1, 2019 Accepting new patients

Locations

106 Shook Rd
Ste 209
Hawley, PA 18428
Phone (570) 977-1294

106 Shook Rd
Ste 204
Hawley, PA 18428
Phone (570) 977-1294

Organizations & group practices 2

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": "1563321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1023661204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 COMMERCE BLVD",
            "city": "DICKSON CITY",
            "state": "PA",
            "postal_code": "185191759",
            "telephone_number": "570-489-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 SHOOK RD STE 209",
            "city": "HAWLEY",
            "state": "PA",
            "postal_code": "184287059",
            "telephone_number": "570-977-1294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 S Main Ave",
            "address_purpose": "LOCATION",
            "city": "Scranton",
            "state": "PA",
            "postal_code": "185042545",
            "country_code": "US",
            "telephone_number": "570-904-7363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARKOVSKY",
        "first_name": "YEKATERINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-17",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014498",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawley, PA

Sources for this page

Verify at the official NPI Registry.