Individual provider Active NPI

Renata M. Cerveira

  • Mental Health Counselor
  • Longwood, FL
National Provider Identifier
1003056086
Registry record updated Mar 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
IMH 5766 Issued in FL
Practice address
320 Crown Oaks Centre Dr
Longwood, FL 32750-6149
Phone
(321) 303-1811
NPI assigned
Mar 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMH 5766 FL Primary

Addresses

Primary practice location

320 Crown Oaks Centre Dr
Longwood, FL 32750-6149

Mailing address

320 Crown Oaks Centre Dr
Longwood, FL 32750-6149
Phone (321) 303-1811

Other identifiers 1

IdentifierTypeStateIssuer
IMH 5766OtherFLREGISTERED MENTAL HEALTH COUNSELOR INTERN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH 5766FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236038400000",
    "number": "1003056086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 CROWN OAKS CENTRE DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506149",
            "telephone_number": "321-303-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CROWN OAKS CENTRE DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506149",
            "telephone_number": "321-303-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVEIRA",
        "first_name": "RENATA",
        "middle_name": "M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH 5766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED MENTAL HEALTH COUNSELOR INTERN",
            "identifier": "IMH 5766",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.