Individual provider Active NPI

Dawn L Peechatka, CACD,CRC,SAP,LPC

  • Community/Behavioral Health Agency
  • Tannersville, PA
National Provider Identifier
1679616627
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
PC002753 Issued in PA
Practice address
Route 611
Tannersville, PA 18372
Phone
(570) 426-5191
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X PC002753 PA
Community/Behavioral Health Agency 251S00000X PC002753 PA Primary

Addresses

Primary practice location

Route 611
Tannersville, PA 18372

Mailing address

PO Box 444
Tannersville, PA 18372-0444
Phone (570) 426-5191

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

State licenses

LicenseStateTypeSpecialty
PC002753PAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1679616627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 444",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "183720444",
            "telephone_number": "570-426-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 611",
            "city": "TANNERSVILLE",
            "state": "PA",
            "postal_code": "18372",
            "telephone_number": "570-426-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEECHATKA",
        "first_name": "DAWN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CACD,CRC,SAP,LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "PC002753",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "PA",
            "license": "PC002753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tannersville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.