Jacquelyn Coughlin, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC013036 Issued in PA

Practice address

237 W Berwick St
Easton, PA 18042-6633

Phone

(610) 972-3560

NPI assigned

Feb 27, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Concern-Professional Services for Children, Youth & Families

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Towanda, PA
  • NPI 1376845479
  NPD

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

{
    "created_epoch": "1614384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614384000000",
    "number": "1689268864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 W BERWICK ST",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180426633",
            "telephone_number": "610-972-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 W BERWICK ST",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180426633",
            "telephone_number": "610-972-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUGHLIN",
        "first_name": "JACQUELYN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-27",
        "last_updated": "2021-02-27",
        "certification_date": "2021-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC013036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Feb 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.