Active NPI
Wigberto Moises Coronel, MS. CLINICAL PSYCHOL
- Mental Health Counselor
- Bullhead City, AZ
National Provider Identifier
1467923136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2100067
- Practice address
- 1099 Hancock Rd
Bullhead City, AZ 86442-5957 - Phone
- (928) 299-3698
- NPI assigned
- Dec 6, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2100067 | AZ | Primary |
Addresses
Primary practice location
1099 Hancock Rd
Bullhead City, AZ 86442-5957
Mailing address
1099 Hancock Rd
Bullhead City, AZ 86442-5957
Phone (928) 299-3698
Other names 1
- Mr. Wigberto Moises Coronel
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2100067 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544054400000",
"number": "1467923136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1099 HANCOCK RD",
"city": "BULLHEAD CITY",
"state": "AZ",
"postal_code": "864425957",
"telephone_number": "928-299-3698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1099 HANCOCK RD",
"city": "BULLHEAD CITY",
"state": "AZ",
"postal_code": "864425957",
"telephone_number": "928-299-3698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORONEL",
"first_name": "WIGBERTO",
"middle_name": "MOISES",
"name_prefix": "Mr.",
"credential": "MS. CLINICAL PSYCHOL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-06",
"last_updated": "2018-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "2100067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "WIGBERTO",
"last_name": "CORONEL",
"middle_name": "MOISES",
"prefix": "MR.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bullhead City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.