Individual provider Active NPI

Theresa Johnson, LPC

  • Professional Counselor
  • Wilkes Barre, PA
National Provider Identifier
1023805793
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC018847 Issued in PA
Practice address
335 S Franklin St
Wilkes Barre, PA 18702-3808
Phone
(570) 825-6425
Fax
(570) 762-9011
NPI assigned
Apr 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC018847 PA Primary

Addresses

Primary practice location

335 S Franklin St
Wilkes Barre, PA 18702-3808

Mailing address

359 Vaughn St
Luzerne, PA 18709-1425
Phone (570) 301-0076

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
I20250817000066 PA Practitioner - Mental Health Counselor 1951800929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

335 S Franklin St
Wilkes Barre, PA 18702-3808
Phone 5708256425581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC018847PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Service Center of Wyoming Valley, Inc CurrentSince Aug 1, 2025 Accepting new patients
Children'S Service Center of Wyoming Valley, Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

133 W Tioga St
Tunkhannock, PA 18657
Phone (570) 836-2722

335 S Franklin St
Wilkes Barre, PA 18702
Phone (570) 825-6425

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": "1745452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1023805793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 VAUGHN ST",
            "city": "LUZERNE",
            "state": "PA",
            "postal_code": "187091425",
            "telephone_number": "570-301-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 S FRANKLIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023808",
            "telephone_number": "570-825-6425",
            "fax_number": "570-762-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THERESA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC018847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.