Individual provider Active NPI

Brandon Gommer, LPC

  • Professional Counselor
  • Plymouth Meeting, PA
National Provider Identifier
1992470629
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC012823 Issued in PA
Practice address
26 E Germantown Pike Unit 553
Plymouth Meeting, PA 19462-1555
Phone
(610) 800-7650
NPI assigned
Aug 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X PC012823 PA
Addiction (Substance Use Disorder) Counselor 101YA0400X PC012823 PA
Mental Health Counselor 101YM0800X PC012823 PA
Professional Counselor 101YP2500X PC012823 PA Primary

Addresses

Primary practice location

26 E Germantown Pike Unit 553
Plymouth Meeting, PA 19462-1555

Mailing address

PO Box 553
Plymouth Meeting, PA 19462-0553
Phone (610) 800-7650

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
I20231208000439 PA Practitioner - Mental Health Counselor 5991154536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

600 N Jackson St
Suite 300
Media, PA 19063-2530
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC012823PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

600 N Jackson St
Ste 300
Media, PA 19063
Phone (610) 557-1991

5830 Ellsworth Ave
Ste 301
Pittsburgh, PA 15232
Phone (412) 208-6279

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": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1992470629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194620553",
            "telephone_number": "610-800-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 E GERMANTOWN PIKE UNIT 553",
            "city": "PLYMOUTH MEETING",
            "state": "PA",
            "postal_code": "194621555",
            "telephone_number": "610-800-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMMER",
        "first_name": "BRANDON",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "PA",
            "license": "PC012823",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "PC012823",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC012823",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC012823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth Meeting, PA

Sources for this page

Verify at the official NPI Registry.