Individual provider Active NPI

Eliel Negron Diaz, LMHC

  • Mental Health Counselor
  • Springfield, MA
National Provider Identifier
1811326648
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
12540 Issued in MA
Practice address
300 Carew St Ste 2
Springfield, MA 01104-2146
Phone
(413) 736-0355
Fax
(413) 734-1651
NPI assigned
Nov 2, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 12540 MA Primary

Addresses

Primary practice location

300 Carew St Ste 2
Springfield, MA 01104-2146

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Other identifiers 1

IdentifierTypeStateIssuer
1303295MedicaidMA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240404001494 MA Practitioner - Mental Health Counselor 4688012099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Ponce School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boston Neurobehavioral Associates, LLCGroup PAC ID 9436142429, 159 clinicians

Practice addresses (Care Compare)

226 Field St
New Bedford, MA 02740-2133
Phone (508) 979-5557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12540MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Neurobehavioral Associates, LLC CurrentSince Dec 5, 2024 Accepting new patients

Locations

226 Field St
New Bedford, MA 02740
Phone (508) 817-5129

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.

NPI Registry JSON

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

{
    "created_epoch": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1811326648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700",
            "fax_number": "413-794-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CAREW ST STE 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011042146",
            "telephone_number": "413-736-0355",
            "fax_number": "413-734-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGRON DIAZ",
        "first_name": "ELIEL",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-02",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "12540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1303295",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.