Active NPI
Mary Jo Baum-McConnell, LPC
- Professional Counselor
- Ebensburg, PA
National Provider Identifier
1689151565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC010477
- Practice address
- 313 W High St
Ebensburg, PA 15931-1549 - Phone
- (814) 205-4004
- Fax
- (814) 205-4013
- NPI assigned
- Jul 24, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC010477 | PA | Primary |
Addresses
Primary practice location
313 W High St
Ebensburg, PA 15931-1549
Mailing address
850 Leonard St
Clearfield, PA 16830-3200
Phone (814) 205-4004
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC010477 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532390400000",
"number": "1689151565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 LEONARD ST",
"city": "CLEARFIELD",
"state": "PA",
"postal_code": "168303200",
"telephone_number": "814-205-4004",
"fax_number": "814-205-4013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 W HIGH ST",
"city": "EBENSBURG",
"state": "PA",
"postal_code": "159311549",
"telephone_number": "814-205-4004",
"fax_number": "814-205-4013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUM-MCCONNELL",
"first_name": "MARY JO",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-24",
"last_updated": "2018-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC010477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ebensburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.