Individual provider Active NPI

Cassandra Ila Laureano, LPC

  • Professional Counselor
  • Wilkes Barre, PA
National Provider Identifier
1720964471
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC019131 Issued in PA
Practice address
21 Academy St
Wilkes Barre, PA 18702-3801
Phone
(703) 010-9355
Fax
(570) 762-9009
NPI assigned
Aug 15, 2025
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC019131 PA Primary

Addresses

Primary practice location

21 Academy St
Wilkes Barre, PA 18702-3801

Mailing address

335 S Franklin St
Wilkes Barre, PA 18702-3808
Phone (570) 825-6425

Other practice location 1

335 S Franklin St
Wilkes Barre, PA 18702-3808
Phone (570) 825-6425

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
I20251009000582 PA Practitioner - Mental Health Counselor 2769989326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thaxton Holistic Wellness CenterGroup PAC ID 2769818418, 22 clinicians

Practice addresses (Care Compare)

1169 Wyoming Ave
Forty Fort, PA 18704-4003
Phone (570) 904-7363

228 S Main Ave
Scranton, PA 18504-2545
Phone (570) 904-7363

254 Daleville Hwy
Covington Township, PA 18444-7951
Phone (570) 904-7363

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thaxton Holistic Wellness Center Professional CurrentSince Dec 1, 2025 Accepting new patients

Locations

1169 Wyoming Ave
Forty Fort, PA 18704
Phone (570) 283-3301

228 S Main Ave
Scranton, PA 18504
Phone (570) 209-5880

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1720964471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 S FRANKLIN ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023808",
            "telephone_number": "570-825-6425",
            "fax_number": "570-762-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ACADEMY ST",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187023801",
            "telephone_number": "703-010-9355",
            "fax_number": "570-762-9009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "335 S Franklin St",
            "address_purpose": "LOCATION",
            "city": "Wilkes Barre",
            "state": "PA",
            "postal_code": "187023808",
            "country_code": "US",
            "telephone_number": "570-825-6425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAUREANO",
        "first_name": "CASSANDRA",
        "middle_name": "ILA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC019131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

Verify at the official NPI Registry.