Nicholas Mediate, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC013854 Issued in PA

Practice address

900 Fieldstone TRL
Easton, PA 18040-7486

Phone

(570) 620-6684

NPI assigned

Oct 18, 2021

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

Interoperability endpoints

• Direct secure messaging: nicholas.mediate.1@32853.direct.athenahealth.com

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.

• Children'S Integrated Center for Success

  • Family Nurse Practitioner
  • Allentown, PA
  • NPI 1447670708
  NPD (past)

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1659034577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 FIELDSTONE TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407486",
            "telephone_number": "570-620-6684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 FIELDSTONE TRL",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180407486",
            "telephone_number": "570-620-6684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDIATE",
        "first_name": "NICHOLAS",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC013854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF SOCIAL WORKERS, MARRIAGE & FAMILY THERAPISTS AND PROFESSIONAL COU",
            "identifier": "PC013854",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey McLeod, MD
• Donald R McNellis, M.D.
• Loren Benjamin Mead II, MD
• Alexander Ayres Mearhoff-Nickum
• Katherine Medei
• Bharat K Mehta, MD
• Ramiz Memon, MD
• Jonathan Menard-Katcher, MD
• Brooke Mendelson, DO
• Victoria Mennona, FNP-BC

• Mental Health Counselor in Easton, PA
• Providers in Easton, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.