Diverge Counseling LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

DIVERGE COUNSELING LLC

Practice address

2800 W 21St St Ste 102
Erie, PA 16506-2980

Phone

(814) 900-4562

Fax

(814) 731-6496

NPI assigned

Sep 5, 2024

Organization subpart

No

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

Authorized official

Name

Madelyn Simmons, LPC, ATRNPI 1285406645

Title

Owner

Phone

(814) 900-4562

Specialties & licenses 1

Addresses

Other names 1

• Diverge Counseling and Connection Doing business as

Locations

Practitioners 1

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

• Madelyn Simmons

  • Mental Health Counselor
  • Erie, PA
  • NPI 1285406645
  NPD Authorized official

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1689409955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W 21ST ST STE 102",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062980",
            "telephone_number": "814-900-4562",
            "fax_number": "814-731-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W 21ST ST STE 102",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062980",
            "telephone_number": "814-900-4562",
            "fax_number": "814-731-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERGE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "MADELYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-900-4562",
        "authorized_official_credential": "LPC, ATR"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diverge Counseling and Connection",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Distefano
• Mary Kathleen Ditullio, CRNP
• Rashell Diuk, LPC
• Bethany Divell, CRNP
• Eric Divell, CRNA
• Garrett Divins
• Adrienne Michele Dixon-McCullum, PH.D
• Clarice Mae Dixson, DO
• Hanna Dmochowska, MD
• Jennifer Ann DO

• Counselor in Erie, PA
• Providers in Erie, PA by specialty
• Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.