Individual provider Active NPI

Daniel Cervantes, MA

  • Mental Health Counselor
  • Columbus, IN
National Provider Identifier
1033626601
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
720 N Marr Rd
Columbus, IN 47201-6660
Phone
(812) 314-3400
NPI assigned
Jan 4, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39004284A IN
Professional Counselor 101YP2500X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

720 N Marr Rd
Columbus, IN 47201-6660

Mailing address

645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691

Other practice location 1

1403 Tanager Dr
Warsaw, IN 46580-2054
Phone (574) 377-9857

Other practice location 2

46 Ems D18 Ln
Syracuse, IN 46567-7907
Phone (574) 377-9857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231221002802 IN Practitioner - Mental Health Counselor 5698125250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerstone of Indiana IncGroup PAC ID 9436138427, 114 clinicians

Practice addresses (Care Compare)

1075 2ND St
Columbus, IN 47201-6855

720 N Marr Rd
Columbus, IN 47201-6660
Phone (812) 314-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Indiana, Inc. Current Accepting new patients
Healing Road LLC Mental Health CurrentSince Feb 12, 2023 Accepting new patients
Centerstone of Indiana, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

720 N Marr Rd
Columbus, IN 47201
Phone (812) 314-3400

Organizations & group practices 3

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": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1033626601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 N MARR RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016660",
            "telephone_number": "812-314-3400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1403 Tanager Dr",
            "address_purpose": "LOCATION",
            "city": "Warsaw",
            "state": "IN",
            "postal_code": "465802054",
            "country_code": "US",
            "telephone_number": "574-377-9857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46 Ems D18 Ln",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "IN",
            "postal_code": "465677907",
            "country_code": "US",
            "telephone_number": "574-377-9857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERVANTES",
        "first_name": "DANIEL",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-04",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39004284A",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.