Active NPI
Sherry Ann Nightingale, LICENSED BEHAVIOR SP
- Addiction (Substance Use Disorder) Counselor
- Dubois, PA
National Provider Identifier
1154034320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- BH002096
- Practice address
- 490 Jeffers Street
Dubois, PA 15801 - Phone
- (814) 371-1100
- NPI assigned
- Jan 3, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | BH002096 | PA | Primary |
Addresses
Primary practice location
490 Jeffers Street
Dubois, PA 15801
Mailing address
793 Old Route 119 Hwy North
Indiana, PA 15701
Phone (724) 465-5576
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH002096 | PA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672704000000",
"number": "1154034320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "793 OLD ROUTE 119 HWY NORTH",
"city": "INDIANA",
"state": "PA",
"postal_code": "15701",
"telephone_number": "724-465-5576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 JEFFERS STREET",
"city": "DUBOIS",
"state": "PA",
"postal_code": "15801",
"telephone_number": "814-371-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NIGHTINGALE",
"first_name": "SHERRY",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LICENSED BEHAVIOR SP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-03",
"last_updated": "2023-01-03",
"certification_date": "2023-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "PA",
"license": "BH002096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dubois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.