Healthcare Provider Details

I. General information

NPI: 1760206957
Provider Name (Legal Business Name): KGS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2024
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 S STATE ST STE 6
CLARKS SUMMIT PA
18411-1590
US

IV. Provider business mailing address

1327 GRAVEL POND RD
CLARKS SUMMIT PA
18411-9457
US

V. Phone/Fax

Practice location:
  • Phone: 570-351-2751
  • Fax:
Mailing address:
  • Phone: 570-351-2751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KELLY VERMEERENSMITH
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LCSW
Phone: 570-351-2751