Individual provider Active NPI

Kerry Howard Caviston, LMHC

  • Mental Health Counselor
  • Leominster, MA
National Provider Identifier
1003425646
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11233 Issued in MA
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

Updated by the provider on Jul 29, 2020

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 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131003207 MA Practitioner - Mental Health Counselor 3072966530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11233MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
New England Center for Mental Health LLC Mental Health CurrentSince Jan 1, 2024 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.

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

Verify at the official NPI Registry.