Individual provider Active NPI

Corey Vansickle, LPC

  • Professional Counselor
  • Canonsburg, PA
National Provider Identifier
1083060057
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1000 Noble Energy Dr Ste 282
Canonsburg, PA 15317-7541
Phone
(717) 744-2453
Fax
(724) 833-9027
NPI assigned
May 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 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 Primary

Addresses

Primary practice location

1000 Noble Energy Dr Ste 282
Canonsburg, PA 15317-7541

Mailing address

111 Highland Ave
Waynesburg, PA 15370-3603
Phone (717) 744-2453

Other practice location 1

955 W Chestnut St Ste 1
Washington, PA 15301-4651
Phone (724) 350-6799

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
I20250106001190 PA Practitioner - Mental Health Counselor 0840728820 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Bloom Counseling and Wellness LLC Professional CurrentSince Nov 1, 2024 Accepting new patients

Locations

1000 Noble Energy Dr
Ste 282
Canonsburg, PA 15317
Phone (717) 744-2453

Interoperability endpoints

  • Direct secure messaging: corey.vansickle.p12@direct.cornerstonecare.nextgenshare.com

Organizations & group practices 1

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1083060057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HIGHLAND AVE",
            "city": "WAYNESBURG",
            "state": "PA",
            "postal_code": "153703603",
            "telephone_number": "717-744-2453",
            "fax_number": "724-833-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NOBLE ENERGY DR STE 282",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153177541",
            "telephone_number": "717-744-2453",
            "fax_number": "724-833-9027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "955 W Chestnut St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "PA",
            "postal_code": "153014651",
            "country_code": "US",
            "telephone_number": "724-350-6799",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANSICKLE",
        "first_name": "COREY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

Verify at the official NPI Registry.