Organization Active NPI

Soaring Mantis Counseling LLC

  • Counselor
  • Reading, PA
National Provider Identifier
1205794138
Registry record updated Jan 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
SOARING MANTIS COUNSELING LLC
Practice address
122 W Lancaster Ave Ste 205
Reading, PA 19607-1874
Phone
(484) 509-1413
NPI assigned
Jan 10, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2026

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

Authorized official

Name
Amber Dominik, LPCNPI 1861062903
Title
Licensed Professional Counselor
Phone
(717) 669-7349

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

122 W Lancaster Ave Ste 205
Reading, PA 19607-1874

Mailing address

45 Wesleyan Dr
Reading, PA 19607-2211
Phone (717) 669-7349

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260504007345 PA Part B Supplier - Clinic/Group Practice 0345718714 Receives reassigned benefits from 1 practitioner
Practice locations: Reading, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1768003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768003200000",
    "number": "1205794138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WESLEYAN DR",
            "city": "READING",
            "state": "PA",
            "postal_code": "196072211",
            "telephone_number": "717-669-7349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W LANCASTER AVE STE 205",
            "city": "READING",
            "state": "PA",
            "postal_code": "196071874",
            "telephone_number": "484-509-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOARING MANTIS COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-10",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A",
        "authorized_official_last_name": "DOMINIK",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "717-669-7349",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.