Individual provider Active NPI

Katie Pancurak

  • Mental Health Counselor
  • Erie, PA
National Provider Identifier
1467062844
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC012488 Issued in PA
Practice address
1330 W 26TH St
Erie, PA 16508-1402
Phone
(814) 459-9300
NPI assigned
Jul 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC012488 PA Primary

Addresses

Primary practice location

1330 W 26TH St
Erie, PA 16508-1402

Mailing address

1330 W 26TH St
Erie, PA 16508-1402
Phone (814) 459-9300

Other practice location 1

1738 W 8th St
Erie, PA 16505-5024
Phone (814) 722-7467

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address safeharbor@upmcdirect.com Health Information Exchange (HIE)

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
I20240106000487 PA Practitioner - Mental Health Counselor 2961853643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Safe Harbor Behavioral Health of Upmc HamotGroup PAC ID 6305743154, 20 clinicians

Practice addresses (Care Compare)

1330 W 26TH St
Erie, PA 16508-1402
Phone (814) 459-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC012488PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Behavioral Health of Upmc Hamot Current Accepting new patients
Safe Harbor Behavioral Health of Upmc Hamot CurrentSince Jan 1, 2024 Accepting new patients
Mark a Borland Mental Health PastSince Aug 1, 2020 Accepting new patients
Millcreek Counseling & Mental Health Advocacy Partnership Corp Mental Health PastSince Aug 1, 2020 Accepting new patients

Locations

120 Washington Towne Blvd N
Edinboro, PA 16412
Phone (814) 734-8647

3910 Caughey Rd
Erie, PA 16506
Phone (814) 580-6818

1330 W 26th St
Erie, PA 16508
Phone (814) 451-2345

Organizations & group practices 4

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": "1596153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1467062844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300",
            "fax_number": "814-456-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W 26TH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165081402",
            "telephone_number": "814-459-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1738 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165055024",
            "country_code": "US",
            "telephone_number": "814-722-7467",
            "fax_number": "814-836-8194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCURAK",
        "first_name": "KATIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-31",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC012488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "safeharbor@upmcdirect.com",
            "affiliation": "N",
            "endpointDescription": "secure UPMC direct address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1330 W 26th St",
            "city": "Erie",
            "state": "PA",
            "country_code": "US",
            "postal_code": "165081402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Erie, PA

Sources for this page

Verify at the official NPI Registry.