Individual provider Active NPI

Toby Nicolosi, MS, LPC

  • Professional Counselor
  • Allentown, PA
National Provider Identifier
1033711882
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC012820 Issued in PA
Practice address
1251 S Cedar Crest Blvd Ste 202a
Allentown, PA 18103-6214
Phone
(610) 402-5766
Fax
(610) 402-5763
NPI assigned
Nov 16, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 PC012820 PA Primary

Addresses

Primary practice location

1251 S Cedar Crest Blvd Ste 202a
Allentown, PA 18103-6214

Mailing address

2100 Mack Blvd FL 4
Allentown, PA 18103-5622
Phone (484) 884-4500

Other practice location 1

726 Church St
Fogelsville, PA 18051-1603
Phone (610) 433-1529

Other practice location 2

732 W Turner St
Allentown, PA 18102-4038
Phone (610) 433-1529

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
I20240405000040 PA Practitioner - Mental Health Counselor 6204274574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

1251 S Cedar Crest Blvd
202A LVPG Consultation Liasion Psychiatry
Allentown, PA 18103-6214
Phone (610) 402-5766

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PC012820PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 21, 2024 Accepting new patients
Lehigh Valley Physician Group CurrentSince Feb 21, 2024 Accepting new patients
Valliere & Counseling Associates, Inc PastSince Oct 2, 2002 Accepting new patients

Locations

1251 S Cedar Crest Blvd
Ste 202A
Allentown, PA 18103
Phone (610) 402-5766

2100 Mack Blvd
Fl 4
Allentown, PA 18103

Organizations & group practices 5

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": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1033711882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MACK BLVD FL 4",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181035622",
            "telephone_number": "484-884-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 S CEDAR CREST BLVD STE 202A",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036214",
            "telephone_number": "610-402-5766",
            "fax_number": "610-402-5763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "726 Church St",
            "address_purpose": "LOCATION",
            "city": "Fogelsville",
            "state": "PA",
            "postal_code": "180511603",
            "country_code": "US",
            "telephone_number": "610-433-1529",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "732 W Turner St",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181024038",
            "country_code": "US",
            "telephone_number": "610-433-1529",
            "fax_number": "610-289-4883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLOSI",
        "first_name": "TOBY",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-16",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.