Active NPI
Madeline Hertzberg
- Professional Counselor
- State College, PA
National Provider Identifier
1437745544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC002004
- Practice address
- 1315 W College Ave
State College, PA 16801-2776 - Phone
- (814) 571-9760
- NPI assigned
- Dec 14, 2020
- Sex
- Female
- Sole proprietor
- No
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 | PC002004 | PA | Primary |
Addresses
Primary practice location
1315 W College Ave
State College, PA 16801-2776
Mailing address
205 Manhasset CT
Port Matilda, PA 16870-7327
Phone (814) 571-9760
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 |
|---|---|---|---|
| PC002004 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608681600000",
"number": "1437745544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 MANHASSET CT",
"city": "PORT MATILDA",
"state": "PA",
"postal_code": "168707327",
"telephone_number": "814-571-9760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 W COLLEGE AVE",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168012776",
"telephone_number": "814-571-9760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERTZBERG",
"first_name": "MADELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-14",
"last_updated": "2020-12-23",
"certification_date": "2020-12-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC002004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.