Individual provider Active NPI

Javier Verdin

  • Mental Health Counselor
  • Palm Beach Gardens, FL
National Provider Identifier
1174915912
Registry record updated Dec 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16499 Issued in FL
Practice address
3307 Northlake Blvd Ste 104
Palm Beach Gardens, FL 33403-1703
Phone
(561) 531-1204
NPI assigned
Mar 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH16499 FL Primary

Addresses

Primary practice location

3307 Northlake Blvd Ste 104
Palm Beach Gardens, FL 33403-1703

Mailing address

3117 31St Way
West Palm Beach, FL 33407-6711

Other practice location 1

5305 Greenwood Ave
West Palm Beach, FL 33407-2451
Phone (561) 557-6651

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

LicenseStateTypeSpecialty
MH16499FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544227200000",
    "number": "1174915912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 31ST WAY",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334076711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 NORTHLAKE BLVD STE 104",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334031703",
            "telephone_number": "561-531-1204"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5305 Greenwood Ave",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334072451",
            "country_code": "US",
            "telephone_number": "561-557-6651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERDIN",
        "first_name": "JAVIER",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-03",
        "last_updated": "2018-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.