Individual provider Active NPI

Cordelia E Wheelock, LMHC

  • Mental Health Counselor
  • Providence, RI
National Provider Identifier
1710033675
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC00292 Issued in RI
Practice address
55 Hope St
Family Service of Rhode Island
Providence, RI 02906-2001
Phone
(401) 331-1350
Fax
(401) 277-3366
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MHC00292 RI Primary

Addresses

Primary practice location

55 Hope St
Family Service of Rhode Island
Providence, RI 02906-2001

Mailing address

411 Orms St
Providence, RI 02908-4824
Phone (401) 331-1350

Other identifiers 3

IdentifierTypeStateIssuer
CW62073MedicaidRI
31626-0OtherBLUE CROSS BLUE SHIELD
413560OtherBLUE CHIP

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
MHC00292RIMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710033675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 ORMS ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084824",
            "telephone_number": "401-331-1350",
            "fax_number": "401-277-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 HOPE ST",
            "address_2": "FAMILY SERVICE OF RHODE ISLAND",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062001",
            "telephone_number": "401-331-1350",
            "fax_number": "401-277-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELOCK",
        "first_name": "CORDELIA",
        "middle_name": "E",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC00292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CW62073",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "31626-0",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "413560",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.