Active NPI
Dominick Costanza
- Professional Counselor
- Wexford, PA
National Provider Identifier
1396078481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC004489
- Practice address
- 306 Osprey CT
Wexford, PA 15090-2509 - Phone
- (724) 331-4306
- NPI assigned
- Sep 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC004489 | PA | Primary |
Addresses
Primary practice location
306 Osprey CT
Wexford, PA 15090-2509
Mailing address
306 Osprey CT
Wexford, PA 15090-2509
Phone (724) 331-4306
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC004489 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1396078481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 OSPREY CT",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150902509",
"telephone_number": "724-331-4306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 OSPREY CT",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150902509",
"telephone_number": "724-331-4306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTANZA",
"first_name": "DOMINICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-08",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC004489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wexford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.