NPIMap

Organization Active NPI

Northern Tier Counseling, Inc.

Doing business as Northern Tier Counseling MH-Psychiatry

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Towanda, PA
National Provider Identifier
1346267374
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
NORTHERN TIER COUNSELING, INC.
Doing business as
Northern Tier Counseling MH-Psychiatry
Practice address
24727 Route 6 Ste 2
Towanda, PA 18848-8257
Phone
(570) 265-0100
Fax
(570) 265-6741
NPI assigned
Jul 16, 2006
Last updated
Mar 25, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Authorized official

Name
Mr. Paul Denault
Title
Ceo
Phone
(570) 265-0100

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

24727 Route 6 Ste 2
Towanda, PA 18848-8257

Mailing address

24727 Route 6 Ste 2
Towanda, PA 18848-8257
Phone (570) 265-0100

Other identifiers 6

IdentifierTypeStateIssuer
1007540580075MedicaidPA
753722OtherPAHIGHMARK BLUE SHIELD
801928OtherPAFPH PROVIDER#-PSYCHIATRY
1007540580040MedicaidPA
1007540580042MedicaidPA
1007540580073MedicaidPA

Other names 1

  • Northern Tier Counseling MH-Psychiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727000681 PA Part B Supplier - Clinic/Group Practice 7113997354 Receives reassigned benefits from 8 practitioners
Practice locations: Towanda, PA

National Provider Directory

National Provider Directory
Tax ID family
Northern Tier Counseling in8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

411 S Main St
Athens, PA 18810
Phone (570) 485-5823

1550 S Main St
Mansfield, PA 16933
Phone (570) 662-7954

356 Loder St
South Waverly, PA 18840
Phone (570) 882-7414

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/northerntiercounseling/r4/

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1346267374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24727 ROUTE 6 STE 2",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188488257",
            "telephone_number": "570-265-0100",
            "fax_number": "570-265-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24727 ROUTE 6 STE 2",
            "city": "TOWANDA",
            "state": "PA",
            "postal_code": "188488257",
            "telephone_number": "570-265-0100",
            "fax_number": "570-265-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN TIER COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "DENAULT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "570-265-0100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007540580075",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "753722",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FPH PROVIDER#-PSYCHIATRY",
            "identifier": "801928",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007540580040",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007540580042",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007540580073",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Tier Counseling MH-Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Towanda, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.