Mario Jose Davila

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

16 Marion St Apt 2
Medford, MA 02155-6220

Phone

(787) 238-1838

NPI assigned

Feb 7, 2022

Last updated

Feb 7, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eliot Community Human Services

  dba Eliot Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, MA
  • NPI 1679648182
  Medicare reassignment NPD
• Eliot Community Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lexington, MA
  • NPI 1932271632
  NPD

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644192000000",
    "number": "1518611730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MARION ST APT 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021556220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MARION ST APT 2",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021556220",
            "telephone_number": "787-238-1838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "MARIO",
        "middle_name": "JOSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-07",
        "last_updated": "2022-02-07",
        "certification_date": "2022-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdavila@eliotchs.org",
            "affiliation": "N",
            "address_1": "16 Marion St Apt 2",
            "city": "Medford",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021556220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel W. Jiang, DMD, PC (Medford Periodontics)
• Kristen Taylor Dansereau
• Mary Helen Darcy, NP
• Dava Davainis, MSW, LICSW
• David M. Petrarca, DDS & Sungyon Bang, DMD, P.C.
• Anne-Laure Davis
• James Lagamo Dawson, D.O.
• DCS Mental Health, Inc
• Keelin M Deasy, MA, MSC, BA
• Wendi Defilippo

• Mental Health Counselor in Medford, MA
• Providers in Medford, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.