Jeremy A Walrath, BSW, MA, LBS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

BH006787 Issued in PA

Practice address

62 Plaza LN
Wellsboro, PA 16901-1766

Phone

(570) 724-7142

Fax

(570) 724-6771

NPI assigned

Jul 13, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1851603344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 PLAZA LN",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011766",
            "telephone_number": "570-724-7142",
            "fax_number": "570-724-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 PLAZA LN",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011766",
            "telephone_number": "570-724-7142",
            "fax_number": "570-724-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALRATH",
        "first_name": "JEREMY",
        "middle_name": "A",
        "credential": "BSW, MA, LBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-13",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "BH006787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Upmc Wellsboro
• Ann R Vayansky, CPNP
• Cathleen M Veach, MD
• Jon L Vogler, PA-C
• Ronald M Waclawik, D.D.S.
• Marc A. Walters, D.C.
• Denielle L Watson
• Courtney Lynn Wattles, OTR/L
• Beth Weaver, CRNP
• Weis Markets Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.