Active NPI
Cosmore Godfrey Marriott, LPC
- Professional Counselor
- Fort Lauderdale, FL
National Provider Identifier
1114682861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PRC1482
- Practice address
- 1015 E Sunrise Blvd Unit 508
Fort Lauderdale, FL 33304-2850 - Phone
- (202) 321-9152
- NPI assigned
- Nov 7, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PRC1482 | DC | Primary |
Addresses
Primary practice location
1015 E Sunrise Blvd Unit 508
Fort Lauderdale, FL 33304-2850
Mailing address
1015 E Sunrise Blvd Unit 508
Fort Lauderdale, FL 33304-2850
Phone (202) 321-9152
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cmarriott@lesdc.org | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PRC1482 | DC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636243200000",
"number": "1114682861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 E SUNRISE BLVD UNIT 508",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333042850",
"telephone_number": "202-321-9152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1015 E SUNRISE BLVD UNIT 508",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333042850",
"telephone_number": "202-321-9152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARRIOTT",
"first_name": "COSMORE",
"middle_name": "GODFREY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-07",
"last_updated": "2021-11-07",
"certification_date": "2021-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "DC",
"license": "PRC1482",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cmarriott@lesdc.org",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1015 E Sunrise Blvd Unit 508",
"city": "Fort Lauderdale",
"state": "FL",
"country_code": "US",
"postal_code": "333042850",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.