Individual provider Active NPI

Craig Clearwater

  • Mental Health Counselor
  • Lancaster, PA
National Provider Identifier
1104200047
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC008264 Issued in PA
Practice address
410 N Prince St
Lancaster, PA 17603-3010
Phone
(717) 560-7917
NPI assigned
Jul 9, 2015
Last updated
Jul 9, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC008264 PA Primary

Addresses

Primary practice location

410 N Prince St
Lancaster, PA 17603-3010

Mailing address

410 N Prince St
Lancaster, PA 17603-3010
Phone (717) 560-7917

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
I20240613002677 PA Practitioner - Mental Health Counselor 3173066594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

410 N Prince St
Lancaster, PA 17603-3010
Phone (717) 560-7917

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
T.W. Ponessa & Associates Counseling Services, Inc. CurrentSince Apr 4, 2024 Accepting new patients

Locations

410 N Prince St
Lancaster, PA 17603

15 S 9th St
Lebanon, PA 17042
Phone (717) 273-5992

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436400000000",
    "number": "1104200047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N PRINCE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033010",
            "telephone_number": "717-560-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N PRINCE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033010",
            "telephone_number": "717-560-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEARWATER",
        "first_name": "CRAIG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC008264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.