Noel Cordova, CADC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.011077 Issued in IL

Practice address

4419 W North Ave
Melrose Park, IL 60160-1021

Phone

(773) 777-7112

NPI assigned

Dec 18, 2015

Last updated

Dec 18, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Group practices

Shift Counseling, P.C.Group PAC ID 7113360256, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Shift Counseling, P.C.

  dba Rebecca Malley LCPC, PC

  • Mental Health Counselor
  • North Riverside, IL
  • NPI 1619480019
  Medicare reassignment Care Compare group NPD
• Youth Outreach Services

  • Community/Behavioral Health Agency
  • Melrose Park, IL
  • NPI 1568916476
  NPD (past)
• Youth Outreach Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Melrose Park, IL
  • NPI 1811227341
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1144685082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601021",
            "telephone_number": "773-777-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601021",
            "telephone_number": "773-777-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "NOEL",
        "credential": "CADC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "32131",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.011077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Melinda Cordero
• Kayla Briana Corirossi, LSW, MSW
• Joaquin U Cortes Sr., MD
• Costco Wholesale Corporation (Costco Optical #1085)
• Costco Wholesale Corporation (Costco Hearing Aid #1085)
• Costco Wholesale Corporation

• Professional Counselor in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.