Active NPI
Kerry Howard Caviston, LMHC
- Mental Health Counselor
- Leominster, MA
National Provider Identifier
1003425646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11233
- Practice address
- 32 Middle St Apt 2
Leominster, MA 01453-3840 - Phone
- (197) 887-0311
- NPI assigned
- Jul 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 11233 | MA | Primary |
Addresses
Primary practice location
32 Middle St Apt 2
Leominster, MA 01453-3840
Mailing address
32 Middle St Apt 2
Leominster, MA 01453-3840
Phone (197) 887-0311
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11233 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New England Center for Mental Health LLC | Mental Health | Current | Accepting new patients |
Locations
289 Great Rd
Ste G1
Acton, MA 01720
Phone (978) 679-1200
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Acton, MA
- NPI 1346560083
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595980800000",
"number": "1003425646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32 MIDDLE ST APT 2",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014533840",
"telephone_number": "197-887-0311"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 MIDDLE ST APT 2",
"city": "LEOMINSTER",
"state": "MA",
"postal_code": "014533840",
"telephone_number": "197-887-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVISTON",
"first_name": "KERRY",
"middle_name": "HOWARD",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-07-29",
"last_updated": "2020-07-29",
"certification_date": "2020-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "11233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Leominster, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.