Michael Cornwall

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CP0225 Issued in NV

Practice address

2110 E Flamingo Rd Ste 207
Las Vegas, NV 89119-5191

Phone

(859) 321-4956

Fax

(702) 472-8635

NPI assigned

Feb 11, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

JLK Home Care IncGroup PAC ID 6709270754, 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 and National Provider Directory roles.

• JLK Home Care Inc

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1851544878
  Medicare reassignment Care Compare group NPD
• Michael Cornwall PHD LLC

  • Professional Counselor
  • Las Vegas, NV
  • NPI 1699531731
  Medicare reassignment NPD Authorized official
• JLK Home Care Inc

  • Community/Behavioral Health Agency
  • Las Vegas, NV
  • NPI 1821730268
  NPD

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

{
    "created_epoch": "1297382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1184921033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 E FLAMINGO RD STE 207",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195191",
            "telephone_number": "859-321-4956",
            "fax_number": "702-472-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 E FLAMINGO RD STE 207",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195191",
            "telephone_number": "859-321-4956",
            "fax_number": "702-472-8635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNWALL",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-11",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NV",
            "license": "CP0225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanzania Cornigans
• Sharon Cornilliac
• Jamire Cornish
• Taiwana Cornish
• Analiza Cornista
• Robert Cornyn
• Alicia Coro, PT
• Emma L. Coro, LMFT
• Frank Corominas
• Alejandra Corona Cifuentes

• Mental Health Counselor in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Mental Health Counselor in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.