Individual provider Active NPI

Romelita Tavarez

  • Mental Health Counselor
  • Indianapolis, IN
National Provider Identifier
1821404880
Registry record updated Jul 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2506 Willowbrook Pkwy
Suite 102
Indianapolis, IN 46205-1564
Phone
(765) 288-1928
Fax
(765) 741-0335
NPI assigned
Jul 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

2506 Willowbrook Pkwy
Suite 102
Indianapolis, IN 46205-1564

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

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

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1821404880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 WILLOWBROOK PKWY",
            "address_2": "SUITE 102",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051564",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVAREZ",
        "first_name": "ROMELITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.