Tiffani Gebhardt

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC014991 Issued in PA

Practice address

1169 Wyoming Ave
Forty Fort, PA 18704-4003

Phone

(570) 904-7363

Fax

(570) 348-4079

NPI assigned

Oct 20, 2022

Last updated

Oct 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thaxton Holistic Wellness CenterGroup PAC ID 2769818418, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Thaxton Holistic Wellness Center

  • Professional Counselor
  • Scranton, PA
  • NPI 1609243898
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1306563374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 S MAIN AVE",
            "city": "SCRANTON",
            "state": "PA",
            "postal_code": "185042545",
            "telephone_number": "570-904-7363",
            "fax_number": "570-348-4079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 WYOMING AVE",
            "city": "FORTY FORT",
            "state": "PA",
            "postal_code": "187044003",
            "telephone_number": "570-904-7363",
            "fax_number": "570-348-4079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBHARDT",
        "first_name": "TIFFANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Fremont, PHD
• Eric Frusciante, D.M.D.
• Kara Furman
• Kathleen Anne Garrity, R.D.
• Shamus Gartley, DDS
• Geisinger Clinic
• Geisinger Wyoming Valley
• Charles Patrick Gelso, BS RPH
• Elizabeth Gernhardt, DO
• Roy Walter Gernhardt III, M.D., PC

• Professional Counselor in Forty Fort, PA
• Providers in Forty Fort, 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 20, 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.