Individual provider Active NPI

Nazareth F Cardoso

  • Mental Health Counselor
  • Brockton, MA
National Provider Identifier
1477847663
Registry record updated Jun 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S83722856 Issued in MA
Practice address
1115 W Chestnut St
Brockton, MA 02301-7501
Phone
(508) 521-2206
NPI assigned
Jun 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2011

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 S83722856 MA Primary

Addresses

Primary practice location

1115 W Chestnut St
Brockton, MA 02301-7501

Mailing address

51 Snell St
Brockton, MA 02301-1644
Phone (508) 649-5618

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
S83722856MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1307232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307232000000",
    "number": "1477847663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 SNELL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011644",
            "telephone_number": "508-649-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 W CHESTNUT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017501",
            "telephone_number": "508-521-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDOSO",
        "first_name": "NAZARETH",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-05",
        "last_updated": "2011-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "S83722856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2011; 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.