Individual provider Active NPI

Kaitlyn Hughes

  • Professional Counselor
  • Media, PA
National Provider Identifier
1770198350
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC012649 Issued in PA
Practice address
1055 E Baltimore Pike Ste 301&303
Media, PA 19063-5173
Phone
(610) 892-3800
NPI assigned
Sep 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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 PC012649 PA Primary

Addresses

Primary practice location

1055 E Baltimore Pike Ste 301&303
Media, PA 19063-5173

Mailing address

2138 Wallace St
Philadelphia, PA 19130-3105
Phone (610) 762-7176

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
I20241003000902 PA Practitioner - Mental Health Counselor 5991236838 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jul 21, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jul 21, 2024 Accepting new patients

Locations

11000 Optum Cir
Eden Prairie, MN 55344
Phone (888) 445-8745

1420 Walnut St
Ste 802
Philadelphia, PA 19102
Phone (267) 629-5334

7 Neshaminy Interplex Dr
Trevose, PA 19053

7 Neshaminy Interplex Dr
Ste 411
Trevose, PA 19053

560 Van Reed Rd
Ste 301
Wyomissing, PA 19610
Phone (610) 378-9601

Interoperability endpoints

  • Direct secure messaging: kaitlyn.hughes.1@28623.direct.athenahealth.com

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": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1770198350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2138 WALLACE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303105",
            "telephone_number": "610-762-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E BALTIMORE PIKE STE 301&303",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635173",
            "telephone_number": "610-892-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "KAITLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.