KELLY A. ROUGHGARDEN LPC
NPI 1750949384
Counselor - Professional in Moosic, PA

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

Active since May 29, 2019PECOS EnrolledAccepts Medicare Assignment

340 MONTAGE MOUNTAIN RD, MOOSIC, PA 18507(570) 346-3686 Get Directions Write a Review

NPPES record last updated: May 29, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kelly A. Roughgarden Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY A. ROUGHGARDEN LPC (NPI 1750949384) is an individual professional provider in Moosic, Pennsylvania and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1750949384

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameKELLY A. ROUGHGARDENCredential: LPC

Location Address340 MONTAGE MOUNTAIN RDMoosic, PA 18507-1707

Mailing Address1535 Quincy AveDunmore, PA 18509-2503 · (570) 498-3129

Phone(570) 346-3686

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMay 29, 2019

✔ NPI 1750949384 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

340 MONTAGE MOUNTAIN RD, Moosic, PA 18507

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly A. Roughgarden Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3870028103

PECOS Enrollment IDI20241125000033

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.