NPIMap

Edinboro Counseling and Psychological Services

Organization Active NPI Professional Counselor · Edinboro, PA

NPI 1669713178 · NPPES record last updated Dec 6, 2022

Key facts

NPI
1669713178
Entity type
Organization (NPI type 2)
Primary specialty
Professional Counselor 101YP2500X
Legal business name
EDINBORO COUNSELING AND PSYCHOLOGICAL SERVICES
Practice address
7052 Route 6N
Edinboro, PA 16412-9610
Phone
(814) 734-3975
Fax
(814) 734-1265
NPI assigned
Mar 7, 2013
Reactivated
Dec 6, 2022
Organization subpart
No

Authorized official

Name
Dr. Victor Masone Jr., PH.D. NPI 1881780435
Title
Psychologist
Phone
(814) 734-3975

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

National Provider Directory

Locations

108 High St
Edinboro, PA 16412
Phone (814) 734-3975

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 101YM0800X
Professional Counselor
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 101YP2500X Yes

Addresses

Primary practice location

7052 Route 6N
Edinboro, PA 16412-9610

Mailing address

7052 Route 6N
Edinboro, PA 16412-9610
Phone (814) 734-3975

Other identifiers

IdentifierTypeStateIssuer
0011606710001MedicaidPA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 6, 2022.

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1669713178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7052 ROUTE 6N",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164129610",
            "telephone_number": "814-734-3975",
            "fax_number": "814-734-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7052 ROUTE 6N",
            "city": "EDINBORO",
            "state": "PA",
            "postal_code": "164129610",
            "telephone_number": "814-734-3975",
            "fax_number": "814-734-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDINBORO COUNSELING AND PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "deactivation_date": "2022-11-29",
        "reactivation_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "MASONE",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "814-734-3975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011606710001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinboro, PA

All providers in Edinboro, PA · Professional Counselor in Pennsylvania

Sources for this page

Verify at the official NPI Registry.