Organization Active NPI

Cumberland Valley Counseling Associates PC

  • Clinical Psychologist
  • Carlisle, PA
National Provider Identifier
1447439054
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS006810-L Issued in PA
Legal business name
CUMBERLAND VALLEY COUNSELING ASSOCIATES PC
Practice address
1200 Walnut Bottom Rd
Suite 311
Carlisle, PA 17015-7766
Phone
(717) 243-1511
Fax
(717) 243-1530
NPI assigned
Oct 31, 2007
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Authorized official

Name
Gwendolyn Pehl Minnix, M.S.,LICENSED PSYCH
Title
President
Phone
(717) 243-1511

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC003026 PA
Clinical Psychologist 103TC0700X PS006810-L PA Primary
Clinical Social Worker 1041C0700X CW013034 PA

Addresses

Primary practice location

1200 Walnut Bottom Rd
Suite 311
Carlisle, PA 17015-7766

Mailing address

1200 Walnut Bottom Rd
Suite 311
Carlisle, PA 17015-7766
Phone (717) 243-1511

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071219000408 PA Part B Supplier - Clinic/Group Practice 5991895534 Receives reassigned benefits from 3 practitioners
Practice locations: Carlisle, PA

National Provider Directory

National Provider Directory

Locations

1200 Walnut Bottom Rd
Ste 31
Carlisle, PA 17015
Phone (717) 243-1511

1200 Walnut Bottom Rd
Ste 311
Carlisle, PA 17015
Phone (717) 243-1511

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": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1447439054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 WALNUT BOTTOM RD",
            "address_2": "SUITE 311",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170157766",
            "telephone_number": "717-243-1511",
            "fax_number": "717-243-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 WALNUT BOTTOM RD",
            "address_2": "SUITE 311",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "170157766",
            "telephone_number": "717-243-1511",
            "fax_number": "717-243-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND VALLEY COUNSELING ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "MINNIX",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "PEHL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-243-1511",
        "authorized_official_credential": "M.S.,LICENSED PSYCH"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC003026",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS006810-L",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW013034",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlisle, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.