Individual provider Active NPI

Metaxia Elizabeth Papademetriou, MA, LPC

  • Professional Counselor
  • Wyomissing, PA
National Provider Identifier
1427530443
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC010694 Issued in PA
Practice address
1105 Berkshire Blvd Ofc 110
Wyomissing, PA 19610-1248
Phone
(610) 374-4963
Fax
(610) 378-5403
NPI assigned
Sep 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC010694 PA
Professional Counselor 101YP2500X PC010694 PA Primary

Addresses

Primary practice location

1105 Berkshire Blvd Ofc 110
Wyomissing, PA 19610-1248

Mailing address

1105 Berkshire Blvd Ofc 110
Wyomissing, PA 19610-1248
Phone (610) 374-4963

Other identifiers 4

IdentifierTypeStateIssuer
1035428280003MedicaidPA
1035428280004MedicaidPA
1035428280002MedicaidPA
1035428280005MedicaidPA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240417001353 PA Practitioner - Mental Health Counselor 2769821289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Guidance CenterGroup PAC ID 1850291303, 22 clinicians

Practice addresses (Care Compare)

1105 Berkshire Blvd
Ofc 110
Wyomissing, PA 19610-1249
Phone (610) 374-4963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PC010694PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Guidance Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

701 Windsor St
Hamburg, PA 19526

3570 Old Route 22
Hamburg, PA 19526
Phone (610) 374-4963

711 Windsor St
Hamburg, PA 19526

1105 Berkshire Blvd
Ofc 110
Wyomissing, PA 19610
Phone (610) 374-4963

1235 Penn Ave
Ste 205206
Wyomissing, PA 19610
Phone (610) 374-4963

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1427530443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 BERKSHIRE BLVD OFC 110",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101248",
            "telephone_number": "610-374-4963",
            "fax_number": "610-378-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BERKSHIRE BLVD OFC 110",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101248",
            "telephone_number": "610-374-4963",
            "fax_number": "610-378-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPADEMETRIOU",
        "first_name": "METAXIA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-06",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC010694",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC010694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035428280003",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035428280004",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035428280002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035428280005",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.