Active NPI
Nevila Bardhi Weagle, LMHC, LMFT
- Mental Health Counselor
- Worcester, MA
National Provider Identifier
1104002062
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LMHC 6312
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6312 | MA | MD | Mental Health Counselor |
| LMHC 6312 | MA | MD | Mental Health Counselor |
| MFC 42392 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth Opportunities Upheld, Inc. | Current | 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
- 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Worcester, MA
- NPI 1245317205
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Worcester, MA
- NPI 1346297504
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.