Active NPI
Adam Bonventre
- Mental Health Counselor
- Glendale, AZ
National Provider Identifier
1154065829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 17235 N 75TH Ave Ste F100
Glendale, AZ 85308-0871 - Phone
- (480) 641-1165
- NPI assigned
- Apr 27, 2022
- 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 | Primary |
Addresses
Primary practice location
17235 N 75TH Ave Ste F100
Glendale, AZ 85308-0871
Mailing address
17235 N 75TH Ave Ste F100
Glendale, AZ 85308-0871
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1154065829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17235 N 75TH AVE STE F100",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853080871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17235 N 75TH AVE STE F100",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853080871",
"telephone_number": "480-641-1165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONVENTRE",
"first_name": "ADAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-27",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.