NPIMap

Organization Active NPI

Centre Counseling and Wellness, LLC

  • Mental Health Counselor
  • State College, PA
National Provider Identifier
1033650932
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC008236 Issued in PA
Legal business name
CENTRE COUNSELING AND WELLNESS, LLC
Practice address
315 S Allen St
Suite 326
State College, PA 16801-4849
Phone
(814) 387-8823
NPI assigned
Mar 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Authorized official

Name
Dr. Jonathan Edwin Stube, LPCNPI 1669854121
Title
Owner
Phone
(814) 387-8823

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X PC008236 PA Primary

Addresses

Primary practice location

315 S Allen St
Suite 326
State College, PA 16801-4849

Mailing address

315 S Allen St
Suite 326
State College, PA 16801-4849
Phone (814) 387-8823

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231012001849 PA Part B Supplier - Clinic/Group Practice 8527413400 Receives reassigned benefits from 5 practitioners
Practice locations: Phoenixville, PA; State College, PA

National Provider Directory

National Provider Directory

Locations

315 S Allen St
Ste 326
State College, PA 16801
Phone (814) 308-0704

2541 E College Ave
Ste 105
State College, PA 16801
Phone (814) 308-0704

315 S Allen St
Ste 117
State College, PA 16801
Phone (814) 308-0704

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1033650932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 S ALLEN ST",
            "address_2": "SUITE 326",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168014849",
            "telephone_number": "814-387-8823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S ALLEN ST",
            "address_2": "SUITE 326",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168014849",
            "telephone_number": "814-387-8823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE COUNSELING AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "STUBE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-387-8823",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC008236",
            "primary": true
        }
    ],
    "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 Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.