MS. TRACY L PEQUIGNOT (NPI# 1639340300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639340300 |
| Entity Type | Individual |
| Full Name | MS. TRACY L PEQUIGNOT |
| Credential | LCSW |
| Practice Address |
7095 Route 287 Wellsboro PA 16901 |
| Mailing Address |
7095 Route 287 Po Box 685 Wellsboro PA 16901-6711 |
| Practice Telephone | 5707245272 |
| Practice Fax Number | 5707244512 |
| Mailing Telephone | 5707245272 |
| Mailing Fax Number | 5707244512 |
| Enumeration Date | 2008-03-20 |
| Last Update Date | 2018-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
CW015745 | PA | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 107 Main St Unit 3, Wellsboro, PA 169011518 | 5707231005 | 5707231006 |
| 206 Main St Ste 5, Blossburg, PA 169121172 | 5707245272 | 5707244512 |
| Po Box 685, Wellsboro, PA 169010685 | (570) 724-5272 | 5707244512 |
| Street Address |
7095 ROUTE 287 |
| City | WELLSBORO |
| State | PA |
| Zip Code | 16901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699754424 | Harbor Counseling | Clinic/Center | 7095 Route 287, Wellsboro, PA 16901-6711 | 2006-01-11 |
| 1366695462 | Brian K Shrawder | Counselor | 7095 Route 287, Wellsboro, PA 16901-6711 | 2008-11-03 |
| 1083880769 | Keith K. Koons | Counselor | 7095 Route 287, Wellsboro, PA 16901-6711 | 2008-05-02 |
| 1588830236 | Richard B Baity II | Counselor | 7095 Route 287, Wellsboro, PA 16901-6711 | 2008-05-02 |
| 1841466513 | Douglas Candelario | Counselor | 7095 Route 287, Wellsboro, PA 16901-6711 | 2008-05-02 |
| 1316113319 | Rosalind E. Statts | Counselor | 7095 Route 287, Wellsboro, PA 16901-6711 | 2008-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053964940 | Alyssa Lapp | Occupational Therapist | 32 Central Avenue, Wellsboro, PA 16901 | 2019-07-19 |
| 1437701190 | Kari Donnele Root | Occupational Therapist | 36 Central Avenue, Wellsboro, PA 16901 | 2019-07-12 |
| 1205377835 | Brett Long | Physical Therapy Assistant | 37 Central Avenue, Wellsboro, PA 16901 | 2017-03-15 |
| 1487072526 | Mary Caitlin Jones | Physical Therapist | 100 Plaza Ln, Wellsboro, PA 16901 | 2014-04-05 |
| 1144650607 | Amy Chalot | Occupational Therapy Assistant | 1883 Shumway Hill Road, Broad Acres Health and Rehabilitation Center, Wellsboro, PA 16901 | 2013-11-20 |
| 1780844209 | Upmc Wellsboro | Pathology | 32 36 Central Avenue, Pathology, Wellsboro, PA 16901 | 2008-06-10 |
| 1639369606 | Well Adjusted Chiropractic Center PC | Chiropractor | 82 East Avenue, Wellsboro, PA 16901 | 2007-07-26 |
| 1538362991 | John W Eaton | Dentist | 23 Water Street, Wellsboro, PA 16901 | 2007-06-06 |
| 1437210242 | James Michael Stewart | Technician/Technologist | 16 Pearl St, Wellsboro, PA 16901 | 2006-12-13 |
| 1508879560 | Edward Jeffrey Candela | Dentist | 16 Water St, Wellsboro, PA 16901 | 2006-08-14 |
| Find all providers in zip 16901 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316345226 | Richard Hayford | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-12-09 |
| 1184032625 | Alyssa Hoffman | Social Worker | 114 East Ave, Wellsboro, PA 16901-1737 | 2014-07-29 |
| 1841613692 | Pamela Suanne Oliver | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-01-30 |
| 1821411737 | Cathleen Marengo | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-01-28 |
| 1548683659 | Erika Peterson | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-01-24 |
| 1184047284 | Susan Groover-van Pelt | Social Worker | 62 Plaza Ln, Wellsboro, PA 16901-1766 | 2014-01-24 |
| 1063842284 | Inner Compass, LLC | Social Worker | 107 Main St Unit 3, Wellsboro, PA 16901-1518 | 2013-11-25 |
| 1144510280 | Tyler O Benelli | Social Worker | 114 East Ave, Wellsboro, PA 16901-1737 | 2011-04-11 |
| 1417189382 | Lori A Makos | Social Worker | 114 East Ave, Wellsboro, PA 16901-1737 | 2009-08-11 |
| 1629211792 | Jeanna E Lloyd | Social Worker | 13 Walnut St, Wellsboro, PA 16901-1513 | 2009-04-20 |
| Find all providers in WELLSBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.