Individual provider Active NPI

Matthew Kornacki, MA, LPC, NCC

  • Professional Counselor
  • Lancaster, PA
National Provider Identifier
1962121566
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC014458 Issued in PA
Practice address
1891 Santa Barbara Dr Ste 102
Lancaster, PA 17601-4106
Phone
(717) 553-1192
Fax
(717) 618-6730
NPI assigned
Aug 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X PC014458 PA
Professional Counselor 101YP2500X PC014458 PA Primary

Addresses

Primary practice location

1891 Santa Barbara Dr Ste 102
Lancaster, PA 17601-4106

Mailing address

1891 Santa Barbara Dr Ste 102
Lancaster, PA 17601-4106
Phone (717) 553-1192

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260123003469 PA Practitioner - Mental Health Counselor 3678050283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Krem Capital IncGroup PAC ID 7416311774, 15 clinicians

Practice addresses (Care Compare)

1891 Santa Barbara Dr
Suite 102
Lancaster, PA 17601-4106
Phone (717) 936-9758

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PC014458PAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Krem Capital, Inc Professional CurrentSince Dec 21, 2025 Accepting new patients
Heartwell Therapy Professional PastSince Jul 28, 2025 Accepting new patients
Move Forward Counseling, LLC Professional PastSince Nov 7, 2025 Accepting new patients

Locations

1891 Santa Barbara Dr
Ste 102
Lancaster, PA 17601
Phone (717) 553-1192

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1962121566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 SANTA BARBARA DR STE 102",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014106",
            "telephone_number": "717-553-1192",
            "fax_number": "717-618-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 SANTA BARBARA DR STE 102",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014106",
            "telephone_number": "717-553-1192",
            "fax_number": "717-618-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNACKI",
        "first_name": "MATTHEW",
        "credential": "MA, LPC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC014458",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC014458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.