Individual provider Active NPI

Paul Woelkers Jr., LPC

  • Mental Health Counselor
  • Waverly, PA
National Provider Identifier
1609772839
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC012173 Issued in PA
Practice address
12 Lily Lake Road
Waverly, PA 18414
Phone
(570) 563-8447
NPI assigned
Oct 15, 2026
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC012173 PA Primary

Addresses

Primary practice location

12 Lily Lake Road
Waverly, PA 18414

Mailing address

1223 Monroe Ave
Dunmore, PA 18509-2807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1792022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1609772839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 MONROE AVE",
            "city": "DUNMORE",
            "state": "PA",
            "postal_code": "185092807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 LILY LAKE ROAD",
            "city": "WAVERLY",
            "state": "PA",
            "postal_code": "18414",
            "telephone_number": "570-563-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOELKERS",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC012173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; 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.