Brenda Daugherty-Shrivastava

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC000561 Issued in PA

Practice address

30 Pinnacle Dr
Clarion, PA 16214-3800

Phone

(814) 223-9914

Fax

(814) 223-9917

NPI assigned

Jan 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primary Health Network

  • Federally Qualified Health Center (FQHC)
  • Sharon, PA
  • NPI 1417932609
  Medicare reassignment NPD
• Primary Health Network

  • Federally Qualified Health Center (FQHC)
  • Emlenton, PA
  • NPI 1750181038
  NPD

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1104156157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SHENANGO AVE",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161461503",
            "telephone_number": "814-223-9914",
            "fax_number": "814-223-9917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PINNACLE DR",
            "city": "CLARION",
            "state": "PA",
            "postal_code": "162143800",
            "telephone_number": "814-223-9914",
            "fax_number": "814-223-9917"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Pembroke Ct",
            "address_purpose": "LOCATION",
            "city": "Greensburg",
            "state": "PA",
            "postal_code": "156016404",
            "country_code": "US",
            "telephone_number": "724-396-1510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUGHERTY-SHRIVASTAVA",
        "first_name": "BRENDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC000561",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC000561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "PC000561",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Curreri, ATC
• Kristen Michelle Custer, MS, LPC
• Christian J Cyphert, DPT
• Darrell J. Datko DO (DJD Anesthesia Associates)
• Darrell J. Datko, DO
• Melissa Hammer Daugherty, LCSW
• Decorte Acupressure Inc
• Brenda Decorte, LPC
• Dustin Michael Defrancisis, PA-C
• Haresh I. Desai, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.