Active NPI
Davidson Wilfredo Baez, MA
- Counselor
- Worcester, MA
National Provider Identifier
1740599851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 255 Park Ave Ste 500
Worcester, MA 01609-1958 - Phone
- (508) 753-2900
- NPI assigned
- Oct 7, 2010
- Last updated
- Jul 21, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary | |
| Counseling Psychologist | 103TC1900X | 2722 | PR |
Addresses
Primary practice location
255 Park Ave Ste 500
Worcester, MA 01609-1958
Mailing address
255 Park Ave Ste 500
Worcester, MA 01609-1958
Phone (508) 753-2900
Other practice location 1
Urb. El Real, Calle Reina #408
San German, PR 00683
Phone (787) 233-2909
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2722 | PR | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centro de Desarrollo Cognitivo | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- San German, PR
- NPI 1265841852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1740599851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 PARK AVE STE 500",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016091958",
"telephone_number": "508-753-2900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 PARK AVE STE 500",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016091958",
"telephone_number": "508-753-2900"
}
],
"practiceLocations": [
{
"address_1": "Urb. El Real, Calle Reina #408",
"address_purpose": "LOCATION",
"city": "San German",
"state": "PR",
"postal_code": "00683",
"country_code": "US",
"telephone_number": "787-233-2909",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAEZ",
"first_name": "DAVIDSON",
"middle_name": "WILFREDO",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-07",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "PR",
"license": "2722",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.