Individual provider Active NPI

Nicholas Jude Kaminski, MS, LPC

  • Professional Counselor
  • Dunmore, PA
National Provider Identifier
1104326313
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC010208 Issued in PA
Practice address
502 N Blakely St
Dunmore, PA 18512-1943
Phone
(570) 299-3135
NPI assigned
Feb 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC010208 PA
Professional Counselor 101YP2500X PC010208 PA Primary

Addresses

Primary practice location

502 N Blakely St
Dunmore, PA 18512-1943

Mailing address

1251 Wyoming Ave
Exeter, PA 18643-1434
Phone (570) 342-8434

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
I20240227000910 PA Practitioner - Mental Health Counselor 3375991342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tiffany Griffiths Psy D and Associates IncGroup PAC ID 5496907776, 14 clinicians

Practice addresses (Care Compare)

502 N Blakely St
Dunmore, PA 18512-1943
Phone (570) 342-8434

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tiffany Griffiths Psy D & Associates Inc Professional CurrentSince Jan 15, 2024 Accepting new patients
Integrated Behavioral Health Services, LLC Professional CurrentSince May 28, 2023 Accepting new patients
Gabriela M Yurkanin DPM PC PastSince Mar 5, 2023 Accepting new patients

Locations

502 N Blakely St
Dunmore, PA 18512
Phone (570) 342-8434

1251 Wyoming Ave
Exeter, PA 18643
Phone (570) 307-9054

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18643/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1104326313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 WYOMING AVE",
            "city": "EXETER",
            "state": "PA",
            "postal_code": "186431434",
            "telephone_number": "570-342-8434",
            "fax_number": "570-299-2521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N BLAKELY ST",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185121943",
            "telephone_number": "570-299-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMINSKI",
        "first_name": "NICHOLAS",
        "middle_name": "JUDE",
        "credential": "MS, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-14",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC010208",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC010208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunmore, PA

Sources for this page

Verify at the official NPI Registry.