Kurt E Goglin, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PS012660 Issued in PA

Practice address

133 W Tioga St
Tunkhannock, PA 18657-1496

Phone

(570) 836-2795

Fax

(570) 836-7103

NPI assigned

Sep 18, 2020

Last updated

Sep 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1609482389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W TIOGA ST",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186571496",
            "telephone_number": "570-836-2795",
            "fax_number": "570-836-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W TIOGA ST",
            "city": "TUNKHANNOCK",
            "state": "PA",
            "postal_code": "186571496",
            "telephone_number": "570-836-2795",
            "fax_number": "570-836-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGLIN",
        "first_name": "KURT",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PS012660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "kgoglin@e-csc.org",
            "affiliation": "N",
            "address_1": "133 W Tioga St",
            "city": "Tunkhannock",
            "state": "PA",
            "country_code": "US",
            "postal_code": "186571496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Professional Counselor in Tunkhannock, PA
• Providers in Tunkhannock, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.