Individual provider Active NPI

Nathaniel Deknatel

  • Counselor
  • Woburn, MA
National Provider Identifier
1023411352
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
452659 Issued in MA
Practice address
500 W Cummings Park
Woburn, MA 01801-6503
Phone
(781) 932-0970
NPI assigned
Oct 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 452659 MA Primary

Addresses

Primary practice location

500 W Cummings Park
Woburn, MA 01801-6503

Mailing address

500 W Cummings Park
Woburn, MA 01801-6503

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
452659MAMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1023411352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W CUMMINGS PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016503",
            "telephone_number": "781-932-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEKNATEL",
        "first_name": "NATHANIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MA",
            "license": "452659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.