Individual provider Active NPI

Geoffrey A Gadow, MA

  • Professional Counselor
  • Mansfield, PA
National Provider Identifier
1740357326
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC012350 Issued in PA
Practice address
1550 S Main St
Mansfield, PA 16933-9586
Phone
(570) 662-7954
NPI assigned
Nov 29, 2006
Last updated
Aug 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Professional Counselor 101YP2500X CC4468 ME
Professional Counselor 101YP2500X PC012350 PA Primary

Addresses

Primary practice location

1550 S Main St
Mansfield, PA 16933-9586

Mailing address

113 Hickey Rd
Wellsboro, PA 16901-8116
Phone (715) 314-1032

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
I20240210000177 PA Practitioner - Mental Health Counselor 7012350671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Tier Counseling, Inc.Group PAC ID 7113997354, 7 clinicians

Practice addresses (Care Compare)

24727 Route 6
Suite 2
Towanda, PA 18848-8257
Phone (570) 265-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CC4468MEMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Tier Counseling, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

1550 S Main St
Mansfield, PA 16933
Phone (570) 662-7954

24727 Route 6
#2
Towanda, PA 18848
Phone (570) 265-0100

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/northerntiercounseling/r4/

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596672000000",
    "number": "1740357326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HICKEY RD",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169018116",
            "telephone_number": "715-314-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 S MAIN ST",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "169339586",
            "telephone_number": "570-662-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GADOW",
        "first_name": "GEOFFREY",
        "middle_name": "A",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC4468",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, PA

Sources for this page

Verify at the official NPI Registry.