Individual provider Active NPI

Marquis Angelo Baskerville

  • Mental Health Counselor
  • Scranton, PA
National Provider Identifier
1295623395
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
116 Larch St
Scranton, PA 18509-2802
Phone
(570) 489-5561
NPI assigned
Jun 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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 Primary

Addresses

Primary practice location

116 Larch St
Scranton, PA 18509-2802

Mailing address

1065 The Hideout
Lake Ariel, PA 18436-9514
Phone (570) 664-3197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1750896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1295623395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 THE HIDEOUT",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "184369514",
            "telephone_number": "570-664-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 LARCH ST",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185092802",
            "telephone_number": "570-489-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASKERVILLE",
        "first_name": "MARQUIS",
        "middle_name": "ANGELO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-26",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scranton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; 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.