Jose Antonio Cordero, ED.M., LAPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

APC007562 Issued in GA

Practice address

175 Gwinnett Dr
Lawrenceville, GA 30046-8444

Phone

(678) 209-2394

NPI assigned

Aug 24, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Unlimited Performance Corp

  • Clinical Psychologist
  • Marietta, GA
  • NPI 1235486903
  Medicare reassignment NPD

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1720690449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 NORTH AVE NE APT 4315",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082413",
            "telephone_number": "812-306-4986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 GWINNETT DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468444",
            "telephone_number": "678-209-2394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDERO",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "credential": "ED.M., LAPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC007562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Don M Coppedge, RPH
• Jennifer Hutcheson Corbin, RDH
• Jessica Corbin, LPC
• Teria K Corbin
• Darrell Frank Corder
• Cordinat Medical Staffing and Consulting
• Shelly Wong Cordsen, LPC
• Core Care Women'S & Children'S Wellness Physical Therapy, LLC
• Karyn Corell, LPC
• Corinne F. Quinn M.D., P.C.

• Mental Health Counselor in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.