Omodele Cordero
Individual provider Active NPI Mental Health Counselor · St Petersburg, FL
NPI 1699349910 · NPPES record last updated May 20, 2021
Key facts
- NPI
- 1699349910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 4024 Central Ave
St Petersburg, FL 33711-1239 - Phone
- (727) 327-7656
- Fax
- (727) 322-2103
- NPI assigned
- May 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Tampa Bay Area Counseling
Practice addresses (Care Compare)
3607 Alt
Suite 19
Palm Harbor, FL 34683-1412
Phone (727) 732-4305
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250218001224 | FL | Practitioner - Mental Health Counselor | 2062932320 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa Bay Area Counseling | Mental Health | Current |
Accepting new patients |
| Mindmetrics | Mental Health | Past |
Accepting new patients |
Locations
3607 Alt 19
Palm Harbor, FL 34683
Phone (727) 732-4305
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
4024 Central Ave
St Petersburg, FL 33711-1239
Mailing address
PO Box 10970
St Petersburg, FL 33733-0970
Phone (727) 327-7656
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | suncoastcenter.org |
Other providers in St Petersburg, FL
- Cora Health Services, Inc
- Cora Rehabilitation
- Coral Reef Adult Day Care Center
- Corazon Medico LLC
- Maureen Mary Corbett
- Martha Rosa Cordoba-Fabelo
- Core Care Group Home LLC
- Mary Antoinette Corey
- John Patrick Corkery
- Caroline Theresa Cormier
All providers in St Petersburg, FL · Mental Health Counselor in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.