Individual provider Active NPI

Wanda Hope Siller, LPC

  • Professional Counselor
  • Pottstown, PA
National Provider Identifier
1447869037
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC001551 Issued in PA
Practice address
404 E High St
Pottstown, PA 19464-5622
Phone
(484) 973-6661
Fax
(610) 323-6058
NPI assigned
Jul 29, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC001551 PA Primary

Addresses

Primary practice location

404 E High St
Pottstown, PA 19464-5622

Mailing address

404 E High St
Pottstown, PA 19464-5622
Phone (484) 973-6661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: No
  • 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
I20250103001001 PA Practitioner - Mental Health Counselor 6204364292 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC001551PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Creek Psychotherapy LLC CurrentSince Nov 18, 2024 Accepting new patients

Locations

900 Heritage Dr
Ste 910
Pottstown, PA 19464
Phone (484) 433-2025

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": "1595980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1447869037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 E HIGH ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194645622",
            "telephone_number": "484-973-6661",
            "fax_number": "610-323-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E HIGH ST",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194645622",
            "telephone_number": "484-973-6661",
            "fax_number": "610-323-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLER",
        "first_name": "WANDA",
        "middle_name": "HOPE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC001551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottstown, PA

Sources for this page

Verify at the official NPI Registry.