Active NPI
Cheryl Medina
- Mental Health Counselor
- East Longmeadow, MA
National Provider Identifier
1710326277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 10916
- Practice address
- 264 N Main St Ste 13
East Longmeadow, MA 01028-1837 - Phone
- (413) 525-1711
- NPI assigned
- Jun 18, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10916 | MA | Primary |
Addresses
Primary practice location
264 N Main St Ste 13
East Longmeadow, MA 01028-1837
Mailing address
439 Oldfield Rd
Chicopee, MA 01013-1439
Phone (413) 557-9462
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10916 | MA | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapeutic Connection, P.C. | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Counselor
- East Longmeadow, MA
- NPI 1336351584
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684886400000",
"number": "1710326277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "439 OLDFIELD RD",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010131439",
"telephone_number": "413-557-9462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 N MAIN ST STE 13",
"city": "EAST LONGMEADOW",
"state": "MA",
"postal_code": "010281837",
"telephone_number": "413-525-1711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "CHERYL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-18",
"last_updated": "2023-05-24",
"certification_date": "2022-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "10916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Longmeadow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.