Individual provider Active NPI

Rachael A Van Tassel, LPC, ATR-BC

  • Professional Counselor
  • Carbondale, PA
National Provider Identifier
1730660655
Registry record updated Aug 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC010610 Issued in PA
Practice address
30-32 N Main St
Carbondale, PA 18407-2304
Phone
(570) 282-1732
NPI assigned
Aug 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2018

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 PC010610 PA Primary

Addresses

Primary practice location

30-32 N Main St
Carbondale, PA 18407-2304

Mailing address

11427 Forest Lake Rd
Montrose, PA 18801-8744
Phone (607) 222-4184

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
I20240305002564 PA Practitioner - Mental Health Counselor 2860837416 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC010610PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Art & Wellness, LLC Current Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1730660655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11427 FOREST LAKE RD",
            "city": "MONTROSE",
            "state": "PA",
            "postal_code": "188018744",
            "telephone_number": "607-222-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30-32 N MAIN ST",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184072304",
            "telephone_number": "570-282-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSEL",
        "first_name": "RACHAEL",
        "middle_name": "A",
        "credential": "LPC, ATR-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC010610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, PA

Sources for this page

Verify at the official NPI Registry.