Krystal Koru Lynn-Tolson, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

278 Packanack Drive
Gouldsboro, PA 18424

Phone

(570) 877-0820

NPI assigned

Sep 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Texas a & M University System, HSC, College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Counseling and Wellness Center of Scranton LLCGroup PAC ID 3072900547, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Counseling & Wellness Center of Scranton LLC

  • Professional Counselor
  • Scranton, PA
  • NPI 1992118111
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1336799550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888",
            "city": "GOULDSBORO",
            "state": "PA",
            "postal_code": "184240888",
            "telephone_number": "570-877-0820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 PACKANACK DRIVE",
            "city": "GOULDSBORO",
            "state": "PA",
            "postal_code": "18424",
            "telephone_number": "570-877-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNN-TOLSON",
        "first_name": "KRYSTAL",
        "middle_name": "KORU",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-19",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "82552",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC017222",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA STATE BOARD OF PROFESSIONAL COUNSELORS",
            "identifier": "PC017222",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PROFESSIONAL COUNSELORS",
            "identifier": "82552",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Bickar, LPC
• Diane M. M. Dellavalle, PHD, RDN, LDN
• Gouldsboro Ambulance Squad Inc
• Keystone Community Resources, Inc.
• Keystone Community Resources, Inc.
• Barbara Reddien Wagner, PT, DPT, MHA
• Alyssa Nicole Woods, MA, LPC, CAADC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.