Peter Ellison, LPC, CCDP-D

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC008997 Issued in PA

Practice address

628 Twin Ponds Rd
Breinigsville, PA 18031-1843

Phone

(484) 263-0197

NPI assigned

Sep 6, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nulton Diagnostic and Treatment Center, PCGroup PAC ID 5294621363, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Nulton Diagnostic & Treatment Center, PC

  • Neurodevelopmental Disabilities Physician
  • Johnstown, PA
  • NPI 1073573010
  Medicare reassignment Care Compare group NPD
• Nulton Diagnostic & Treatment Center, PC.

  • Community/Behavioral Health Agency
  • Johnstown, PA
  • NPI 1649515552
  NPD

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1831646066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "628 TWIN PONDS RD",
            "city": "BREINIGSVILLE",
            "state": "PA",
            "postal_code": "180311843",
            "telephone_number": "484-263-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "628 TWIN PONDS RD",
            "city": "BREINIGSVILLE",
            "state": "PA",
            "postal_code": "180311843",
            "telephone_number": "484-263-0197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "PETER",
        "credential": "LPC, CCDP-D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-06",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC008997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Davis, LPN
• Meredith A Dempsey, PHARMD, BCPS
• Melissa Ditaranto, LPC
• Sara B Duda, LCSW
• Ese Duke, PT
• Hillary Paige Evans, LCSW
• Faith and Works LLC
• Jeremy James Falgout, LPC,NCC
• Fountain of Hope Homecare Services LLC
• Kathryn M Friel, LPC

• Professional Counselor in Breinigsville, PA
• Providers in Breinigsville, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.