NPIMap

Organization Active NPI

Community Counseling Center of Mercer County

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Greenville, PA
National Provider Identifier
1285892208
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
437028 Issued in PA
Legal business name
COMMUNITY COUNSELING CENTER OF MERCER COUNTY
Practice address
77 N Main St
Greenville, PA 16125-1781
Phone
(724) 588-6490
Fax
(724) 588-6475
NPI assigned
May 27, 2008
Last updated
May 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Authorized official

Name
Mr. Angelo Stamoolis, M ED
Title
Chief Executive Officer
Phone
(724) 981-7141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 437028 PA Primary

Addresses

Primary practice location

77 N Main St
Greenville, PA 16125-1781

Mailing address

2201 E State St
Hermitage, PA 16148-2727
Phone (724) 981-7141

Other identifiers 1

IdentifierTypeStateIssuer
100000380MedicaidPA

National Provider Directory

National Provider Directory
Tax ID family
Community Counseling Center of Mercer County3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211846400000",
    "number": "1285892208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 E STATE ST",
            "city": "HERMITAGE",
            "state": "PA",
            "postal_code": "161482727",
            "telephone_number": "724-981-7141",
            "fax_number": "724-981-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 N MAIN ST",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161251781",
            "telephone_number": "724-588-6490",
            "fax_number": "724-588-6475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY COUNSELING CENTER OF MERCER COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2008-05-27",
        "status": "A",
        "authorized_official_last_name": "STAMOOLIS",
        "authorized_official_first_name": "ANGELO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "724-981-7141",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M ED"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "437028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100000380",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; 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.