Organization Active NPI

Peace of Mind Therapy

  • Professional Counselor
  • Allentown, PA
National Provider Identifier
1265293229
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
PEACE OF MIND THERAPY
Practice address
1011 Brookside Rd Ste 220
Allentown, PA 18106-9025
Phone
(484) 793-2629
NPI assigned
Jan 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Authorized official

Name
Amanda Shaffer Dobrowolski, LPCNPI 1477977031
Title
Owner
Phone
(484) 793-2629

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
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1011 Brookside Rd Ste 220
Allentown, PA 18106-9025

Mailing address

1011 Brookside Rd Ste 220
Allentown, PA 18106-9025
Phone (484) 793-2629

Other names 1

  • Peace of Mind Therapy LLC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240417000350 PA Part B Supplier - Clinic/Group Practice 6709225295 Receives reassigned benefits from 1 practitioner
Practice locations: Allentown, PA

National Provider Directory

National Provider Directory

Locations

1011 Brookside Rd
Ste 220
Allentown, PA 18106
Phone (484) 793-2629

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": "1705449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705449600000",
    "number": "1265293229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BROOKSIDE RD STE 220",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069025",
            "telephone_number": "484-793-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BROOKSIDE RD STE 220",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069025",
            "telephone_number": "484-793-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE OF MIND THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A",
        "authorized_official_last_name": "DOBROWOLSKI",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "SHAFFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-793-2629",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peace of Mind Therapy LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; 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.