Individual provider Active NPI

Gerard Corneau, LMHC

  • Mental Health Counselor
  • Cranston, RI
National Provider Identifier
1467625566
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC00425 Issued in RI
Practice address
1471 Elmwood Ave
Cranston, RI 02910-3849
Phone
(401) 784-3636
Fax
(401) 784-3636
NPI assigned
Apr 9, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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 MHC00425 RI Primary

Addresses

Primary practice location

1471 Elmwood Ave
Cranston, RI 02910-3849

Mailing address

162 Collins Rd
Ashaway, RI 02804-2509
Phone (401) 742-4286

Other identifiers 2

IdentifierTypeStateIssuer
GC70295MedicaidRI
GH57134MedicaidRI

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
MHC00425RIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Healthcare Inc Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1467625566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 COLLINS RD",
            "city": "ASHAWAY",
            "state": "RI",
            "postal_code": "028042509",
            "telephone_number": "401-742-4286",
            "fax_number": "401-789-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 ELMWOOD AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029103849",
            "telephone_number": "401-784-3636",
            "fax_number": "401-784-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEAU",
        "first_name": "GERARD",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC00425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GC70295",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.