Organization Active NPI

Gena Patackas LPC LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Peckville, PA
National Provider Identifier
1497590491
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GENA PATACKAS LPC LLC
Practice address
1005 Main St Ste 3
Peckville, PA 18452-2166
Phone
(570) 382-3122
NPI assigned
Jul 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Authorized official

Name
Eugena Therese Patackas, LPCNPI 1003299397
Title
Licensed Professional Counselor
Phone
(570) 382-3122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1005 Main St Ste 3
Peckville, PA 18452-2166

Mailing address

1005 Main St Ste 3
Peckville, PA 18452-2166
Phone (570) 382-3122

Other practice location 1

106 Colburn Ave
Clarks Summit, PA 18411-1569
Phone (570) 382-3122

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250408001725 PA Part B Supplier - Clinic/Group Practice 9638693997 Receives reassigned benefits from 1 practitioner
Practice locations: Clarks Summit, PA; Peckville, PA; Olyphant, PA

National Provider Directory

National Provider Directory

Locations

106 Colburn Ave
Clarks Summit, PA 18411
Phone (570) 382-3122

1005 Main St
Ste 3
Peckville, PA 18452
Phone (570) 382-3122

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741824000000",
    "number": "1497590491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAIN ST STE 3",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184522166",
            "telephone_number": "570-382-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAIN ST STE 3",
            "city": "PECKVILLE",
            "state": "PA",
            "postal_code": "184522166",
            "telephone_number": "570-382-3122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "106 Colburn Ave",
            "address_purpose": "LOCATION",
            "city": "Clarks Summit",
            "state": "PA",
            "postal_code": "184111569",
            "country_code": "US",
            "telephone_number": "570-382-3122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENA PATACKAS LPC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A",
        "authorized_official_last_name": "PATACKAS",
        "authorized_official_first_name": "EUGENA",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "570-382-3122",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peckville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.