Active NPI
Gwen Jan Cross, LPC
- Counselor
- Philadelphia, PA
National Provider Identifier
1700285186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- PC008634
- Practice address
- 6122 Ridge Ave
Philadelphia, PA 19128-1603 - Phone
- (215) 487-1330
- Fax
- (215) 487-1641
- NPI assigned
- Aug 21, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | PC008634 | PA | Primary |
Addresses
Primary practice location
6122 Ridge Ave
Philadelphia, PA 19128-1603
Mailing address
6122 Ridge Ave
Philadelphia, PA 19128-1603
Phone (215) 487-1330
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
| License | State | Type | Specialty |
|---|---|---|---|
| PC008634 | PA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Matthew J. Mauriello, Ma, P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- West Chester, PA
- NPI 1033554076
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451865600000",
"number": "1700285186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6122 RIDGE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191281603",
"telephone_number": "215-487-1330",
"fax_number": "215-487-1641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6122 RIDGE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191281603",
"telephone_number": "215-487-1330",
"fax_number": "215-487-1641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSS",
"first_name": "GWEN",
"middle_name": "JAN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-21",
"last_updated": "2016-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "PA",
"license": "PC008634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.