NPIMap

Organization Active NPI

Watershed Counseling Services, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North East, PA
National Provider Identifier
1548778202
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
PC010131 Issued in PA
Legal business name
WATERSHED COUNSELING SERVICES, LLC
Practice address
143 W. Main St.
Suite 110
North East, PA 16428-1333
Phone
(814) 347-5018
Fax
(814) 347-5186
NPI assigned
Jan 16, 2018
Last updated
Nov 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Angela Frank, LPC, NCC, CAADCNPI 1316462799
Title
Owner/Director
Phone
(814) 347-5018

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X PC010131 PA Primary
Adult Mental Health Clinic/Center 261QM0850X PC010131 PA
Adolescent and Children Mental Health Clinic/Center 261QM0855X PC010131 PA

Addresses

Primary practice location

143 W. Main St.
Suite 110
North East, PA 16428-1333

Mailing address

143 West Main Street
Suite 110
North East, PA 16428-1333
Phone (814) 347-5018

Other identifiers 4

IdentifierTypeStateIssuer
319006OtherNATIONAL CERTIFIED COUNSELOR
PC010131OtherPALICENSED PROFESSIONAL COUNSELOR
12348OtherPACERTIFIED ADVANCED ALCOHOL & DRUG COUNSELOR
1035120880001MedicaidPA

National Provider Directory

National Provider Directory

Locations

110 E Main St
Ste 1
North East, PA 16428
Phone (814) 347-5018

143 W Main St
Ste 110
North East, PA 16428
Phone (814) 347-5018

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1516060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1548778202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 WEST MAIN STREET",
            "address_2": "SUITE 110",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164281333",
            "telephone_number": "814-347-5018",
            "fax_number": "814-347-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 W. MAIN ST.",
            "address_2": "SUITE 110",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164281333",
            "telephone_number": "814-347-5018",
            "fax_number": "814-347-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSHED COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-16",
        "last_updated": "2024-11-04",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "FRANK",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "814-347-5018",
        "authorized_official_credential": "LPC, NCC, CAADC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "PC010131",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "PC010131",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "PA",
            "license": "PC010131",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFIED COUNSELOR",
            "identifier": "319006",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "PC010131",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED ADVANCED ALCOHOL & DRUG COUNSELOR",
            "identifier": "12348",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1035120880001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North East, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.