Caren Boukalis Cisse, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1489 Baltimore Pike Ste 250
Springfield, PA 19064-3974

Phone

(610) 544-2110

NPI assigned

Oct 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: caren.cisse.1@28623.direct.athenahealth.com

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.

• Optum Behavioral Care of Connecticut, P.C.

  • Counseling Psychologist
  • Philadelphia, PA
  • NPI 1811778988
  Medicare reassignment NPD
• Hopewell Psychology LLC

  • Psychologist
  • West Chester, PA
  • NPI 1649084914
  NPD
• Optum Behavioral Care of Connecticut, P.C.

  • Clinical Social Worker
  • Providence, RI
  • NPI 1730972944
  NPD
• Springfield Psychological PC

  • Mental Health Counselor
  • Springfield, PA
  • NPI 1295705317
  NPD (past)

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1285350827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 BALTIMORE PIKE STE 250",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643974",
            "telephone_number": "610-544-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 BALTIMORE PIKE STE 250",
            "city": "SPRINGFIELD",
            "state": "PA",
            "postal_code": "190643974",
            "telephone_number": "610-544-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISSE",
        "first_name": "CAREN",
        "middle_name": "BOUKALIS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Children'S Hospital of Philadlephia
• Melanie-Rose Chiponis, PT, DPT
• Shaivya Choudhary
• Edward C Cikowski, DO
• Patricia Janeen Cipollone, OTR/L
• Elizabeth Clark
• Taylor Clark, MS, CCC-SLP
• Grace Clements
• Jesse A Coale, PA-C
• Lucretia Lynn Colquitt, CRNP

• Professional Counselor in Springfield, PA
• Providers in Springfield, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.