Active NPI
Vincent Charles Guardia, MED
- Mental Health Counselor
- Yarmouth Port, MA
National Provider Identifier
1740317858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 112
- Practice address
- 947 RT 6a
Yarmouth Port, MA 02675 - Phone
- (508) 362-3609
- Fax
- (508) 362-3609
- NPI assigned
- Feb 27, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 112 | MA | Primary |
Addresses
Primary practice location
947 RT 6a
Yarmouth Port, MA 02675
Mailing address
PO Box 39
HCA Medical Billing
Marston Mills, MA 02648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891596 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240724001079 | MA | Practitioner - Mental Health Counselor | 3375837586 | Practice locations: Yarmouth Port, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1978
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
35 Avon Rd
Yarmouth Port, MA 02675-1404
Phone (508) 362-3609
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740317858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 39",
"address_2": "HCA MEDICAL BILLING",
"city": "MARSTON MILLS",
"state": "MA",
"postal_code": "02648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "947 RT 6A",
"city": "YARMOUTH PORT",
"state": "MA",
"postal_code": "02675",
"telephone_number": "508-362-3609",
"fax_number": "508-362-3609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUARDIA",
"first_name": "VINCENT",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "MED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "112",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891596",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yarmouth Port, MA
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.
- 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.