Individual provider Active NPI

Otoniel Carrasquillo Bonano, MA., M.ED. (C)

  • Counselor
  • Worcester, MA
National Provider Identifier
1265978035
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
16 Breck St Unit 1B
Worcester, MA 01605-2839
Phone
(787) 391-9851
NPI assigned
Jan 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

16 Breck St Unit 1B
Worcester, MA 01605-2839

Mailing address

16 Breck St Unit 1B
Worcester, MA 01605-2839
Phone (787) 391-9851

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1265978035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BRECK ST UNIT 1B",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052839",
            "telephone_number": "787-391-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BRECK ST UNIT 1B",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052839",
            "telephone_number": "787-391-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO BONANO",
        "first_name": "OTONIEL",
        "name_prefix": "Prof.",
        "credential": "MA., M.ED. (C)",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.