NPIMap

Organization Active NPI

Forensic Counseling Associates LLC

  • Mental Health Counselor
  • Mount Pocono, PA
National Provider Identifier
1821304544
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
FORENSIC COUNSELING ASSOCIATES LLC
Practice address
1385 Pocono Blvd.
Forensic Counseling Associates, LLC
Mt. Pocono, PA 18344
Phone
(570) 460-4379
Fax
(570) 421-3600
NPI assigned
Aug 19, 2010
Last updated
Jul 15, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
FORENSIC COUNSELING ASSOCIATES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Authorized official

Name
Lori Bertanzetti, LCSWNPI 1629292008
Title
Owner
Phone
(570) 460-4379

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Social Worker 104100000X NU

Addresses

Primary practice location

1385 Pocono Blvd.
Forensic Counseling Associates, LLC
Mt. Pocono, PA 18344

Mailing address

1385 Pocono Blvd.
Forensic Counseling Associates, LLC
Mt. Pocono, PA 18344
Phone (570) 460-4379

Other identifiers 1

IdentifierTypeStateIssuer
102550736MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110125000375 PA Part B Supplier - Clinic/Group Practice 7012196926 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Pocono, PA

National Provider Directory

National Provider Directory
Tax ID family
Forensic Counseling Assoc2 organizations share this tax ID, including this one
Part of
Forensic Counseling Assoc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1821304544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 POCONO BLVD.",
            "address_2": "FORENSIC COUNSELING ASSOCIATES, LLC",
            "city": "MT. POCONO",
            "state": "PA",
            "postal_code": "18344",
            "telephone_number": "570-460-4379",
            "fax_number": "570-421-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 POCONO BLVD.",
            "address_2": "FORENSIC COUNSELING ASSOCIATES, LLC",
            "city": "MT. POCONO",
            "state": "PA",
            "postal_code": "18344",
            "telephone_number": "570-460-4379",
            "fax_number": "570-421-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORENSIC COUNSELING ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FORENSIC COUNSELING ASSOCIATES LLC",
        "enumeration_date": "2010-08-19",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "BERTANZETTI",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-460-4379",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102550736",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pocono, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.