Individual provider Active NPI

Nevila Bardhi Weagle, LMHC, LMFT

  • Mental Health Counselor
  • Worcester, MA
National Provider Identifier
1104002062
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC 6312 Issued in MA
Practice address
20 Cedar St
Worcester, MA 01609-2520
Phone
(508) 753-5425
Fax
(508) 753-9625
NPI assigned
Jan 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 42392 CA
Mental Health Counselor 101YM0800X 6312 MA
Mental Health Counselor 101YM0800X LMHC 6312 MA Primary

Addresses

Primary practice location

20 Cedar St
Worcester, MA 01609-2520

Mailing address

20 Cedar St
Worcester, MA 01609-2520
Phone (508) 753-5425

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
I20240306002610 MA Practitioner - Mental Health Counselor 4981040565 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6312MAMDMental Health Counselor
LMHC 6312MAMDMental Health Counselor
MFC 42392CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Opportunities Upheld, Inc. CurrentSince Jan 13, 2024 Accepting new patients
Children'S Friend, Inc. Past Accepting new patients

Locations

135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youinc/r4/

Organizations & group practices 2

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": "1199923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1104002062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CEDAR ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092520",
            "telephone_number": "508-753-5425",
            "fax_number": "508-753-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CEDAR ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092520",
            "telephone_number": "508-753-5425",
            "fax_number": "508-753-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAGLE",
        "first_name": "NEVILA",
        "middle_name": "BARDHI",
        "name_prefix": "Mrs.",
        "credential": "LMHC, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-10",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 42392",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6312",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC 6312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.