William R Killgore Jr., LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC002979 Issued in PA

Practice address

35 E Green St
Nanticoke, PA 18634-2414

Phone

(570) 762-2583

Fax

(570) 300-2629

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nanticoke Counseling Services PC

  • Professional Counselor
  • Nanticoke, PA
  • NPI 1831550599
  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430697600000",
    "number": "1639221237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E GREEN ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186342414",
            "telephone_number": "570-762-2583",
            "fax_number": "570-300-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E GREEN ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186342414",
            "telephone_number": "570-762-2583",
            "fax_number": "570-300-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLGORE",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2015-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC002979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "587349000",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Peter Jurta, DPM
• Janine Kelley, NCC
• Melissa J. Kelly, PA-C
• Bradley A Kessler, RPH
• Danielle Kieck
• Kimberly Ann Klinges, COTA/L
• Ann Adora Konycki
• Alyssa Korman
• Christine Kropiewnicki, RPH
• Caroline Elizabeth Kudrich, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.