Individual provider Active NPI

Steven R Cardozo, MA

  • Mental Health Counselor
  • Wakefield, RI
National Provider Identifier
1700159605
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
55 Cherry LN
Wakefield, RI 02879-3617
Phone
(401) 789-1367
Fax
(401) 789-6744
NPI assigned
Feb 23, 2012
Last updated
Jun 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

55 Cherry LN
Wakefield, RI 02879-3617

Mailing address

4705 Old Post Rd Unit a
Charlestown, RI 02813-1842
Phone (401) 364-7705

Other identifiers 1

IdentifierTypeStateIssuer
SC97096MedicaidRI

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1329955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1700159605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 OLD POST RD UNIT A",
            "city": "CHARLESTOWN",
            "state": "RI",
            "postal_code": "028131842",
            "telephone_number": "401-364-7705",
            "fax_number": "401-364-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CHERRY LN",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793617",
            "telephone_number": "401-789-1367",
            "fax_number": "401-789-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDOZO",
        "first_name": "STEVEN",
        "middle_name": "R",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-23",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SC97096",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.