NPIMap

Organization Active NPI

Metamorphosis LLC

Doing business as Metamorphosis Counseling

  • Mental Health Counselor
  • Erie, PA
National Provider Identifier
1942904925
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
METAMORPHOSIS LLC
Doing business as
Metamorphosis Counseling
Practice address
2800 W 21St St Ste 103
Erie, PA 16506-2980
Phone
(814) 790-4003
NPI assigned
Mar 27, 2023
Last updated
Mar 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Jessica Frick, LPCNPI 1164045977
Title
Owner
Phone
(814) 790-4003

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2800 W 21St St Ste 103
Erie, PA 16506-2980

Mailing address

2800 W 21St St Ste 103
Erie, PA 16506-2980
Phone (814) 790-4003

Other names 1

  • Metamorphosis Counseling Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251215000015 PA Part B Supplier - Clinic/Group Practice 2163916438 Receives reassigned benefits from 1 practitioner
Practice locations: Erie, PA

National Provider Directory

National Provider Directory

Locations

2800 W 21st St
Ste 103
Erie, PA 16506
Phone (814) 790-4003

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1942904925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 W 21ST ST STE 103",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062980",
            "telephone_number": "814-790-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 W 21ST ST STE 103",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165062980",
            "telephone_number": "814-790-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "FRICK",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-790-4003",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metamorphosis Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Erie, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.