Active NPI
Lorraine P Side, MA MS RN CS APRN
- Addiction (Substance Use Disorder) Counselor
- Perkiomenville, PA
National Provider Identifier
1811084098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 2151 Deep Creek Rd
Perkiomenville, PA 18074 - Phone
- (215) 541-9089
- Fax
- (215) 679-3144
- NPI assigned
- Oct 6, 2006
- Last updated
- Sep 11, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | RN248822L | PA | |
| Professional Counselor | 101YP2500X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
2151 Deep Creek Rd
Perkiomenville, PA 18074
Mailing address
2151 Deep Creek Rd
Perkiomenville, PA 18074
Phone (215) 541-9089
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005815320 | Other | AETNA | |
| 0492730000 | Other | KEYSTONE & AMERIHEALTH |
Other names 1
- Lorraine P Costello
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist, Master of Arts, Master of Science, Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1811084098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2151 DEEP CREEK RD",
"city": "PERKIOMENVILLE",
"state": "PA",
"postal_code": "18074",
"telephone_number": "215-541-9089",
"fax_number": "215-679-3144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2151 DEEP CREEK RD",
"city": "PERKIOMENVILLE",
"state": "PA",
"postal_code": "18074",
"telephone_number": "215-541-9089",
"fax_number": "215-679-3144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDE",
"first_name": "LORRAINE",
"middle_name": "P",
"name_prefix": "Mrs.",
"credential": "MA MS RN CS APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-06",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "PA",
"license": "RN248822L",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0005815320",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE & AMERIHEALTH",
"identifier": "0492730000",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LORRAINE",
"last_name": "COSTELLO",
"middle_name": "P",
"credential": "MA MS RN CS APRN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Perkiomenville, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.