Individual provider Active NPI

Emireth Rodriguez Cancino

  • Mental Health Counselor
  • Williamsburg, VA
National Provider Identifier
1619768108
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701014851 Issued in VA
Practice address
1101 Professional Dr Ste B
Williamsburg, VA 23185-3301
Phone
(757) 969-8639
NPI assigned
May 14, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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 0701014851 VA Primary

Addresses

Primary practice location

1101 Professional Dr Ste B
Williamsburg, VA 23185-3301

Mailing address

1101 Professional Dr Ste B
Williamsburg, VA 23185-3301

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
0701014851VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Invicta Wellness Center CurrentSince May 18, 2025 Accepting new patients
Grace D. Shortt, LCSW Acsw LLC PastSince May 18, 2025 Accepting new patients

Locations

1101 Professional Dr
Ste B
Williamsburg, VA 23185
Phone (757) 338-6492

Organizations & group practices 2

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": "1747180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1619768108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PROFESSIONAL DR STE B",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 PROFESSIONAL DR STE B",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231853301",
            "telephone_number": "757-969-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ CANCINO",
        "first_name": "EMIRETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701014851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.