MEDICARE: C2 COUNSELING GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1780529255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C2 COUNSELING GROUP LLC

Provider Business Mailing Address
First Line	:	480 PIERCE ST STE 108
Second Line	:
City	:	KINGSTON
State	:	PA
Zip	:	18704-5512
Country	:	US
Telephone Number	:	570-855-8787
Fax Number	:	570-262-4786

Provider Business Practice Location Address
First Line	:	480 PIERCE ST STE 108
Second Line	:
City	:	KINGSTON
State	:	PA
Zip	:	18704-5512
Country	:	US
Telephone Number	:	570-262-4786
Fax Number	:	570-763-7852

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	ANN COOK
Credential	:	LPC
Telephone Number	:	570-262-4788

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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