Active NPI
Keystone Counseling and Evaluation Services
- Professional Counselor
- Lock Haven, PA
National Provider Identifier
1790099372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC 002227
- 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
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC 002227 | PA | Primary |
| Professional Counselor | 101YP2500X | PC002741 | PA | |
| Professional Counselor | 101YP2500X | |||
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | CW019892 | PA | |
| Psychiatry Physician | 2084P0800X | MD051832L | PA | |
| Child & Adolescent Psychiatry Physician | 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
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1026826640002 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Professional Counselor
- Lock Haven, PA
- NPI 1114180098
PA, Professional
-
- Professional Counselor
- Lock Haven, PA
- NPI 1043502156
PA, Professional
-
- Social Worker
- Lock Haven, PA
- NPI 1245072370
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": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1026826640002",
"state": "PA"
}
],
"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.