Emerald Grove Wellness LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EMERALD GROVE WELLNESS LLC

Practice address

214 Brickyard Rd
Mars, PA 16046-3006

Phone

(724) 766-3825

Fax

(334) 344-7725

NPI assigned

Nov 8, 2020

Last updated

Nov 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Ganter, LPCNPI 1194351775

Title

Owner

Phone

(724) 766-3825

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Ganter, LPC

  • Professional Counselor
  • Cranberry TWP, PA
  • NPI 1194351775
  NPD Authorized official

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604793600000",
    "number": "1104427806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BRICKYARD RD",
            "city": "MARS",
            "state": "PA",
            "postal_code": "160463006",
            "telephone_number": "724-766-3825",
            "fax_number": "334-344-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BRICKYARD RD",
            "city": "MARS",
            "state": "PA",
            "postal_code": "160463006",
            "telephone_number": "724-766-3825",
            "fax_number": "334-344-7725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 N Meadows Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Wexford",
            "state": "PA",
            "postal_code": "150908369",
            "country_code": "US",
            "telephone_number": "724-766-3825",
            "fax_number": "334-344-7725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMERALD GROVE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-08",
        "last_updated": "2020-11-08",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "GANTER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-766-3825",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sean Patrick Finn, MPT

• Professional Counselor in Mars, PA
• Providers in Mars, 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 8, 2020; 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.