Mark Anthony E. Devera

Key facts

NPI

1225313620

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

Practice address

2501 Waimano Home Rd
Pearl City, HI 96782-1478

Phone

(808) 454-1411

Fax

(808) 454-0659

NPI assigned

Oct 17, 2011

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Benchmark Behavioral Health Mental Illness Community Based Residential Treatment Facility · Pearl City, HI · NPI 1346476942
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 17, 2011.

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1225313620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 WAIMANO HOME RD",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967821478",
            "telephone_number": "808-454-1411",
            "fax_number": "808-454-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 WAIMANO HOME RD",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967821478",
            "telephone_number": "808-454-1411",
            "fax_number": "808-454-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERA",
        "first_name": "MARK",
        "middle_name": "ANTHONY E.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl City, HI

• Dept. of Health-Hawaii-Child and Adolescent Mental Health Division
• Dept. of Health-Hawaii-Developmental Disabilities Division Cmu5
• Dept. of Health-Hawaii-Developmental Disabilities Division Cmu6
• Dept. of Health-Hawaii-Developmental Disabilities Division Cmu7
• Dept. of Health-Hawaii-Developmental Disabilities Division Cmu8
• Diamond Head Dental Care PCG Corp
• Joseph Lincoln Diaz Jr.
• Diane Domingo-Nakasone
• Chad Domingo
• John Cornelius Donkervoet, PH.D.

All providers in Pearl City, HI · Mental Health Counselor in Hawaii