Individual provider Active NPI

Tatyana Todorova

  • Mental Health Counselor
  • Quakertown, PA
National Provider Identifier
1689150088
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
PC012352 Issued in PA
Practice address
5666 Clymer Rd
Quakertown, PA 18951-3264
Phone
(215) 538-3488
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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 PC012352 PA Primary

Addresses

Primary practice location

5666 Clymer Rd
Quakertown, PA 18951-3264

Mailing address

2540 S Law St
Allentown, PA 18103-6813
Phone (484) 695-7274

Other practice location 1

1101 Northampton St
Easton, PA 18042-4152
Phone (610) 559-8151 ext. 234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109003878 PA Practitioner - Mental Health Counselor 3779934286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

257 Brodhead Rd
Bethlehem, PA 18017-8938
Phone (484) 526-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC012352PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke'S Physician Group, Inc. Current Accepting new patients
St Luke'S Physician Group Inc CurrentSince Dec 19, 2023 Accepting new patients
St. Luke'S Physician Group Inc CurrentSince Dec 19, 2023 Accepting new patients

Locations

257 Brodhead Rd
Bethlehem, PA 18017
Phone (484) 503-3057

801 Ostrum St
Fountain Hill, PA 18015
Phone (610) 954-2200

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1689150088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2540 S LAW ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036813",
            "telephone_number": "484-695-7274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5666 CLYMER RD",
            "city": "QUAKERTOWN",
            "state": "PA",
            "postal_code": "189513264",
            "telephone_number": "215-538-3488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Northampton St",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "PA",
            "postal_code": "180424152",
            "country_code": "US",
            "telephone_number": "610-559-8151 x234",
            "fax_number": "610-559-9056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TODOROVA",
        "first_name": "TATYANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC012352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quakertown, PA

Sources for this page

Verify at the official NPI Registry.