NPIMap

Organization Active NPI

Keystone Counseling and Evaluation Services

  • Professional Counselor
  • Lock Haven, PA
National Provider Identifier
1790099372
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC 002227 Issued in PA
Legal business name
KEYSTONE COUNSELING AND EVALUATION SERVICES
Practice address
120 S Highland St
Lock Haven, PA 17745-2812
Phone
(570) 748-7173
Fax
(570) 748-5717
NPI assigned
Aug 5, 2010
Last updated
Jan 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Authorized official

Name
Sarah Santucci
Title
Coo
Phone
(570) 748-7173

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X PC 002227 PA Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X PC002741 PA
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X CW019892 PA
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X MD051832L PA
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X MD051832L PA

Addresses

Primary practice location

120 S Highland St
Lock Haven, PA 17745-2812

Mailing address

120 S Highland St
Lock Haven, PA 17745-2812
Phone (570) 748-7173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171121001767 PA Part B Supplier - Clinic/Group Practice 3274890561 Receives reassigned benefits from 11 practitioners
Practice locations: Lock Haven, PA

National Provider Directory

National Provider Directory

Locations

120 S Highland St
Lock Haven, PA 17745
Phone (570) 660-7588

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1790099372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S HIGHLAND ST",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177452812",
            "telephone_number": "570-748-7173",
            "fax_number": "570-748-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S HIGHLAND ST",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177452812",
            "telephone_number": "570-748-7173",
            "fax_number": "570-748-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE COUNSELING AND EVALUATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "SANTUCCI",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "570-748-7173"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC 002227",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC002741",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019892",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD051832L",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "PA",
            "license": "MD051832L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lock Haven, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.