Individual provider Active NPI

Erica Cervantez

  • Professional Counselor
  • Capulin, CO
National Provider Identifier
1043414568
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC003470 Issued in CO
Practice address
8435 County Road Y
Capulin, CO 81124-5035
Phone
(719) 480-9715
NPI assigned
Jun 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC003470
Professional Counselor 101YP2500X LPC003470 CO Primary

Addresses

Primary practice location

8435 County Road Y
Capulin, CO 81124-5035

Mailing address

PO Box 14
Capulin, CO 81124-0014
Phone (719) 480-9715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20260415000880 CO Practitioner - Mental Health Counselor 0345716643 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC003470COMDProfessional Counselor

Networks

  • CO HMO D-SNP
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO C-SNP
  • CO HMO

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": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1043414568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14",
            "city": "CAPULIN",
            "state": "CO",
            "postal_code": "811240014",
            "telephone_number": "719-480-9715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8435 COUNTY ROAD Y",
            "city": "CAPULIN",
            "state": "CO",
            "postal_code": "811245035",
            "telephone_number": "719-480-9715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERVANTEZ",
        "first_name": "ERICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": "LPC003470",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC003470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Capulin, CO

Sources for this page

Verify at the official NPI Registry.