Individual provider Active NPI

Koren Anderson, MA, LPC

  • Professional Counselor
  • Lancaster, PA
National Provider Identifier
1184975161
Registry record updated Jan 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC006369 Issued in PA
Practice address
790 New Holland Ave
Lancaster, PA 17602-2137
Phone
(717) 390-0353
Fax
(717) 390-1812
NPI assigned
Oct 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2017

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 PC006369 PA
Professional Counselor 101YP2500X PC006369 PA Primary

Addresses

Primary practice location

790 New Holland Ave
Lancaster, PA 17602-2137

Mailing address

PO Box 597
Mountville, PA 17554-0597
Phone (717) 285-7121

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
I20240403003726 PA Practitioner - Mental Health Counselor 8729426176 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
Community Services Group IncGroup PAC ID 1052201571, 32 clinicians

Practice addresses (Care Compare)

1902 Olde Homestead Lane
Lancaster, PA 17601-5824
Phone (717) 390-0353

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PC006369PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Services Group, Inc. CurrentSince Feb 4, 2024 Accepting new patients

Locations

790 New Holland Ave
Lancaster, PA 17602
Phone (717) 293-5104

1902 Olde Homestead Ln
Lancaster, PA 17601
Phone (717) 285-7121

1000 Commerce Park Dr
Ste 110
Williamsport, PA 17701
Phone (570) 323-6944

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485561600000",
    "number": "1184975161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 597",
            "city": "MOUNTVILLE",
            "state": "PA",
            "postal_code": "175540597",
            "telephone_number": "717-285-7121",
            "fax_number": "717-285-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 NEW HOLLAND AVE",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176022137",
            "telephone_number": "717-390-0353",
            "fax_number": "717-390-1812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KOREN",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2017-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC006369",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC006369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.