George P Dymiotis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC007117 Issued in PA

Practice address

647 Philadelphia St Ste 402
Indiana, PA 15701-3923

Phone

(765) 404-6582

Fax

(814) 690-2075

NPI assigned

Jan 21, 2010

Sex

Male

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1881925485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 PHILADELPHIA ST STE 402",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013923",
            "telephone_number": "765-404-6582",
            "fax_number": "814-690-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 PHILADELPHIA ST STE 402",
            "city": "INDIANA",
            "state": "PA",
            "postal_code": "157013923",
            "telephone_number": "765-404-6582",
            "fax_number": "814-690-2075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "670 N 36th St",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479054474",
            "country_code": "US",
            "telephone_number": "765-446-8412 x247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DYMIOTIS",
        "first_name": "GEORGE",
        "middle_name": "P",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-21",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002113A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC007117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.