Individual provider Active NPI

Shannon Lynn Wyzkoski, LPC

  • Mental Health Counselor
  • Pittsburgh, PA
National Provider Identifier
1285990630
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC005963 Issued in PA
Practice address
5250 Caste Dr
Pittsburgh, PA 15236-1502
Phone
(412) 469-9771
NPI assigned
Apr 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC005963 PA Primary

Addresses

Primary practice location

5250 Caste Dr
Pittsburgh, PA 15236-1502

Mailing address

4025 Hazeljack Dr
Bethel Park, PA 15102-2323
Phone (412) 427-9034

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260601002823 PA Practitioner - Mental Health Counselor 3577033422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5168 Campbells Run Rd
Suite 204
Pittsburgh, PA 15205-9761

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC005963PAMDMental Health Counselor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1285990630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 HAZELJACK DR",
            "city": "BETHEL PARK",
            "state": "PA",
            "postal_code": "151022323",
            "telephone_number": "412-427-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 CASTE DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152361502",
            "telephone_number": "412-469-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYZKOSKI",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC005963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.