Individual provider Active NPI

Brooke Kaefer-Daum

  • Addiction (Substance Use Disorder) Counselor
  • McKeesport, PA
National Provider Identifier
1477061174
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
331 Shaw Ave
McKeesport, PA 15132-2918
Phone
(412) 675-6498
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

331 Shaw Ave
McKeesport, PA 15132-2918

Mailing address

500 Walnut St FL 3
McKeesport, PA 15132-2801
Phone (412) 675-6498

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
I20240328001074 PA Practitioner - Mental Health Counselor 0547607384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mon Yough Community Services Inc CurrentSince Mar 8, 2024 Accepting new patients
Mon Yough Community Services, Inc CurrentSince Mar 8, 2024 Accepting new patients

Locations

335 Shaw Ave
McKeesport, PA 15132
Phone (412) 586-2801

331 Shaw Ave
McKeesport, PA 15132
Phone (412) 664-6590

500 Walnut St
Fl 3
McKeesport, PA 15132
Phone (412) 675-6498

Organizations & group practices 2

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1477061174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WALNUT ST FL 3",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151322801",
            "telephone_number": "412-675-6498",
            "fax_number": "412-675-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SHAW AVE",
            "city": "MCKEESPORT",
            "state": "PA",
            "postal_code": "151322918",
            "telephone_number": "412-675-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAEFER-DAUM",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKeesport, PA

Sources for this page

Verify at the official NPI Registry.