Edward F Cornell III, M.DIV.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

501 Lombard St
New Haven, CT 06513-2910

Phone

(203) 787-2207

NPI assigned

Dec 5, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Accepts the Medicare-approved amount as payment in full

Group practices

Shoreline Pastoral Counseling LLCGroup PAC ID 5294179883, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Shoreline Pastoral Counseling LLC

  • Counselor
  • Guilford, CT
  • NPI 1497401673
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1154699155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LOMBARD ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065132910",
            "telephone_number": "203-787-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 LOMBARD ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065132910",
            "telephone_number": "203-787-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNELL",
        "first_name": "EDWARD",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "M.DIV.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornell Scott Hill Health Corporation
• Cornell Scott Hill Health Corporation
• Cornell Scott Hill Health Corporation
• Cornell Scott Hill Health Corporation
• Cornell Scott-Hill Health Corporation
• Jennifer L Cornell, APRN
• Daniel Marc Cornfeld, MD
• Joshua Cornman-Homonoff, MD
• Simon Correa Gaviria, MD, MMSC
• Tomas Correa Gaviria, MD

• All providers in New Haven, CT
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; 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.