Active NPI
Edwin Alexander Gomez
- Mental Health Counselor
- North Andover, MA
National Provider Identifier
1124536131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 13003
- Practice address
- 370 Sutton St
North Andover, MA 01845-1517 - Phone
- (781) 248-8891
- NPI assigned
- Jan 12, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 13003 | MA | Primary |
Addresses
Primary practice location
370 Sutton St
North Andover, MA 01845-1517
Mailing address
370 Sutton St
North Andover, MA 01845-1517
Phone (781) 248-8891
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 |
|---|---|---|---|
| 13003 | MA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656374400000",
"number": "1124536131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "370 SUTTON ST",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018451517",
"telephone_number": "781-248-8891"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 SUTTON ST",
"city": "NORTH ANDOVER",
"state": "MA",
"postal_code": "018451517",
"telephone_number": "781-248-8891"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "EDWIN",
"middle_name": "ALEXANDER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-12",
"last_updated": "2022-06-28",
"certification_date": "2022-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "13003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.