Healthcare Provider Details

I. General information

NPI: 1609740414
Provider Name (Legal Business Name): NEXTGEN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 MAIN ST
DICKSON CITY PA
18519-1317
US

IV. Provider business mailing address

502 W 7TH ST STE 100
ERIE PA
16502-1333
US

V. Phone/Fax

Practice location:
  • Phone: 570-397-0285
  • Fax:
Mailing address:
  • Phone: 570-397-0285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JONATHON DAVID WASP
Title or Position: PROJECT DIRECTOR
Credential: MS
Phone: 570-397-0285