Active NPI
Maria T Deaugustino, LPC
- Professional Counselor
- West Middlesex, PA
National Provider Identifier
1831213784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC001064
- Practice address
- 3143 Main St Ste 3
West Middlesex, PA 16159-3419 - Phone
- (724) 674-1594
- NPI assigned
- Mar 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PC001064 | PA | |
| Professional Counselor | 101YP2500X | PC001064 | PA | Primary |
Addresses
Primary practice location
3143 Main St Ste 3
West Middlesex, PA 16159-3419
Mailing address
25 Stonehouse LN
New Wilmington, PA 16142-1623
Phone (724) 674-1594
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110704 | Other | PA | VALUE OPTIONS VENDOR NUMB |
| 001308035 | Other | PA | MANAGED CARE VENDOR NUMBE |
| 001578297 | Other | PA | KEYSTONE BLUE WEST |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC001064 | PA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clover Psychological Association | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- New Castle, PA
- NPI 1124182134
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1831213784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 STONEHOUSE LN",
"city": "NEW WILMINGTON",
"state": "PA",
"postal_code": "161421623",
"telephone_number": "724-674-1594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3143 MAIN ST STE 3",
"city": "WEST MIDDLESEX",
"state": "PA",
"postal_code": "161593419",
"telephone_number": "724-674-1594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAUGUSTINO",
"first_name": "MARIA",
"middle_name": "T",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-18",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "PA",
"license": "PC001064",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC001064",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS VENDOR NUMB",
"identifier": "110704",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED CARE VENDOR NUMBE",
"identifier": "001308035",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE BLUE WEST",
"identifier": "001578297",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Middlesex, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.