Active NPI
Miquel Cordova
- Mental Health Counselor
- Weymouth, MA
National Provider Identifier
1700304037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 541 Main St Ste 303
Weymouth, MA 02190-1845 - Phone
- (781) 331-7866
- NPI assigned
- Sep 7, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
541 Main St Ste 303
Weymouth, MA 02190-1845
Mailing address
PO Box 6441
Plymouth, MA 02362-6441
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S31899005 | Other | MA | DRIVER'S LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504742400000",
"number": "1700304037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6441",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023626441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 MAIN ST STE 303",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021901845",
"telephone_number": "781-331-7866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORDOVA",
"first_name": "MIQUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-09-07",
"last_updated": "2017-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICENSE",
"identifier": "S31899005",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Weymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.