Individual provider Active NPI

Victoria Cestodio

  • Mental Health Counselor
  • Worcester, MA
National Provider Identifier
1508648197
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
10004347 Issued in MA
Practice address
30 Park Ave
Worcester, MA 01605-3945
Phone
(774) 317-0095
NPI assigned
Oct 18, 2023
Last updated
May 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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 10004347 MA Primary

Addresses

Primary practice location

30 Park Ave
Worcester, MA 01605-3945

Mailing address

30 Park Ave
Worcester, MA 01605-3945
Phone (774) 317-0095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260210003991 MA Practitioner - Mental Health Counselor 4789163650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12 Etre Dr
Worcester, MA 01604-1408

135 Gold Star Blvd
Worcester, MA 01606-2738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10004347MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Youth Opportunities Upheld, Inc. CurrentSince Jan 7, 2026 Accepting new patients

Locations

135 Gold Star Blvd
Worcester, MA 01606
Phone (508) 459-6400

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/youinc/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1508648197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053945",
            "telephone_number": "774-317-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 PARK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053945",
            "telephone_number": "774-317-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CESTODIO",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-18",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "10004347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.