Julia Lieback

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

317 Fremont St
West Pittston, PA 18643-2219

Phone

(570) 472-8938

NPI assigned

Aug 31, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thaxton Holistic Wellness CenterGroup PAC ID 2769818418, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Thaxton Holistic Wellness Center

  • Professional Counselor
  • Scranton, PA
  • NPI 1609243898
  Medicare reassignment Care Compare group NPD
• Coven Counseling

  • Professional Counselor
  • West Pittston, PA
  • NPI 1497544506
  NPD Authorized official

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1154107639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 FREMONT ST",
            "city": "WEST PITTSTON",
            "state": "PA",
            "postal_code": "186432219",
            "telephone_number": "570-472-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 FREMONT ST",
            "city": "WEST PITTSTON",
            "state": "PA",
            "postal_code": "186432219",
            "telephone_number": "570-472-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBACK",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Richard Klaproth
• Charles Lajeunesse, PH.D.
• Cecily Lamberti
• Tessa Claire Leck, M.S., LBS
• Robert Lewis
• Frederick Locey, LAT
• Carmen Michael Marranca
• Meredith Melvin-Cosgrove, LSW
• Michael C Baloga DPM, PC
• Michael Scott Miller, RN

• Professional Counselor in West Pittston, PA
• Providers in West Pittston, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.