Individual provider Active NPI

Sylvie B Acoulon, LCSW

  • Social Worker
  • Matamoras, PA
National Provider Identifier
1962653790
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
058520-1 Issued in NY
Practice address
1011 Pennsylvania Ave
Matamoras, PA 18336-1713
Phone
(570) 961-3361
Fax
(570) 961-3364
NPI assigned
Oct 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 058520-1 NY Primary

Addresses

Primary practice location

1011 Pennsylvania Ave
Matamoras, PA 18336-1713

Mailing address

1011 Pennsylvania Ave
Matamoras, PA 18336-1713
Phone (570) 491-5359

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
I20180227002443 PA Practitioner - Clinical Social Worker 7618238007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
John G Kuna Psy D and Associates LLCGroup PAC ID 5890950281, 24 clinicians

Practice addresses (Care Compare)

1011 Pennsylvania Ave
Matamoras, PA 18336-1713
Phone (570) 961-3361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
058520-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
John G Kuna Psy D & Associates LLC CurrentSince Jan 21, 2018 Accepting new patients

Locations

1011 Pennsylvania Ave
Matamoras, PA 18336
Phone (570) 491-4728

4101 Birney Ave
Moosic, PA 18507
Phone (507) 961-3361

Organizations & group practices 1

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": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1962653790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 PENNSYLVANIA AVE",
            "city": "MATAMORAS",
            "state": "PA",
            "postal_code": "183361713",
            "telephone_number": "570-491-5359",
            "fax_number": "570-491-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 PENNSYLVANIA AVE",
            "city": "MATAMORAS",
            "state": "PA",
            "postal_code": "183361713",
            "telephone_number": "570-961-3361",
            "fax_number": "570-961-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOULON",
        "first_name": "SYLVIE",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "058520-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Matamoras, PA

Sources for this page

Verify at the official NPI Registry.