NPIMap

Organization Active NPI

Luzerne/Wyoming Counties Drug and Alcohol Program

  • Addiction (Substance Use Disorder) Counselor
  • Wilkes-Barre, PA
National Provider Identifier
1215027602
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
LUZERNE/WYOMING COUNTIES DRUG AND ALCOHOL PROGRAM
Practice address
20 N Pennsylvania Ave
Penn Place Building Suite 218
Wilkes-Barre, PA 18701-3509
Phone
(570) 826-8790
Fax
(570) 826-3079
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Michael Donahue, CAC
Title
D&a Program Administrator
Phone
(570) 826-8790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary

Addresses

Primary practice location

20 N Pennsylvania Ave
Penn Place Building Suite 218
Wilkes-Barre, PA 18701-3509

Mailing address

20 N Pennsylvania Ave
Penn Place Building Suite 218
Wilkes-Barre, PA 18701-3509
Phone (570) 826-8790

National Provider Directory

National Provider Directory
Tax ID family
Luzerne Wyoming Counties Mental Health Mental Retardation Program5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

20 N Pennsylvania Ave
Ste 218
Wilkes Barre, PA 18701
Phone (570) 826-8790

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215027602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N PENNSYLVANIA AVE",
            "address_2": "PENN PLACE BUILDING SUITE 218",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "187013509",
            "telephone_number": "570-826-8790",
            "fax_number": "570-826-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N PENNSYLVANIA AVE",
            "address_2": "PENN PLACE BUILDING SUITE 218",
            "city": "WILKES-BARRE",
            "state": "PA",
            "postal_code": "187013509",
            "telephone_number": "570-826-8790",
            "fax_number": "570-826-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUZERNE/WYOMING COUNTIES DRUG AND ALCOHOL PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DONAHUE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "D&A PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "570-826-8790",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes-Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.