Carol Mack, PSY.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC003007 Issued in PA

Practice address

454 N. Claude a. Lord Blvd.
Pottsville, PA 17901-2706

Phone

(570) 622-1025

Fax

(570) 628-4344

NPI assigned

Dec 3, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Psychological Associates of Schuylkill County, LLC

  • Psychologist
  • Pottsville, PA
  • NPI 1578534442
  NPD (past)

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1063714566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 N. CLAUDE A. LORD BLVD.",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012706",
            "telephone_number": "570-622-1025",
            "fax_number": "570-628-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 N. CLAUDE A. LORD BLVD.",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179012706",
            "telephone_number": "570-622-1025",
            "fax_number": "570-628-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC003007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Lutz, MSPT
• Sean Lyons, LSW
• Kimberly Maasz, PA-C
• Joseph Maawad, DMD
• Nathan Macdonald
• David Neil Macknis, PTA
• Franco Madaffari, P.T.
• Kayla Maddy
• Joab Zephaniah Magara, FNP, CRNP
• Pauline Olendo Magara, PMHNP-BC

• Professional Counselor in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.