Charles Arthur Soldevilla
Individual provider Active NPI Mental Health Counselor · Brockton, MA
NPI 1821313792 · NPPES record last updated Apr 2, 2010
Key facts
- NPI
- 1821313792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 172 Sumner St W
Brockton, MA 02301-1046 - Phone
- (508) 427-6519
- NPI assigned
- Apr 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Brockton Area Multi-Services, Inc.
Practice addresses (Care Compare)
288 Bedford St
Whitman, MA 02382-1820
Phone (781) 447-6425
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240312000099 | MA | Practitioner - Mental Health Counselor | 1557705050 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8959 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brockton Area Multi-Services, Inc. | Mental Health | Current |
Accepting new patients |
| Whitman Counseling | Past |
Accepting new patients |
Locations
288 Bedford St
Whitman, MA 02382
Phone (781) 447-6425
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
172 Sumner St W
Brockton, MA 02301-1046
Mailing address
172 Sumner St W
Brockton, MA 02301-1046
Phone (508) 427-6519
Other providers in Brockton, MA
- Floripes G Soares
- Jason Soares Sr.
- Nina Leigh Soares
- Sophal Sok
- Hawa Sokona
- Olivia Sonnhalter
- Anothai Soonsawat
- George P Sorescu
- Nicole Sorey
- Tolulope Sorinmade
All providers in Brockton, MA · Mental Health Counselor in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.