NPIMap

Organization Active NPI

West End Counseling & Wellness, LLC

  • Clinical Psychologist
  • Allentown, PA
National Provider Identifier
1528547387
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
WEST END COUNSELING & WELLNESS, LLC
Practice address
1011 Brookside Rd Ste 122
Allentown, PA 18106-9020
Phone
(610) 569-0252
Fax
(484) 460-2470
NPI assigned
Aug 11, 2018
Last updated
Mar 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Authorized official

Name
Dr. Lisa P. Coulter, PHDNPI 1992281786
Title
Owner / Provider
Phone
(610) 569-0252

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Professional Counselor 101YP2500X NU
Clinical Psychologist 103TC0700X NU Primary
Counseling Psychologist 103TC1900X NU
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

1011 Brookside Rd Ste 122
Allentown, PA 18106-9020

Mailing address

1011 Brookside Rd Ste 122
Allentown, PA 18106-9020
Phone (610) 569-0252

Other identifiers 1

IdentifierTypeStateIssuer
1036060860001MedicaidPA

Other names 1

  • Lisa P Coulter Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181016002561 PA Part B Supplier - Clinic/Group Practice 2365794500 Receives reassigned benefits from 16 practitioners
Practice locations: Allentown, PA

National Provider Directory

National Provider Directory

Locations

1011 Brookside Rd
Ste 122
Allentown, PA 18106
Phone (610) 569-0252

5000 W Tilghman St
Ste 370
Allentown, PA 18104
Phone (610) 569-0252

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1533945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1528547387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 BROOKSIDE RD STE 122",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069020",
            "telephone_number": "610-569-0252",
            "fax_number": "484-460-2470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 BROOKSIDE RD STE 122",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181069020",
            "telephone_number": "610-569-0252",
            "fax_number": "484-460-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST END COUNSELING & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-11",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "COULTER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER / PROVIDER",
        "authorized_official_telephone_number": "610-569-0252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036060860001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lisa P Coulter",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lisa P Coulter",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.