Active NPI
Abigail Nedved, MA, QMHP
- Mental Health Counselor
- Fairview Heights, IL
National Provider Identifier
1891336731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 8 Executive Dr
Fairview Heights, IL 62208-1345 - Phone
- (618) 688-4782
- NPI assigned
- Oct 2, 2019
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
8 Executive Dr
Fairview Heights, IL 62208-1345
Mailing address
325 M St
Edwardsville, IL 62025-1023
Phone (712) 358-1036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569974400000",
"number": "1891336731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 M ST",
"city": "EDWARDSVILLE",
"state": "IL",
"postal_code": "620251023",
"telephone_number": "712-358-1036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 EXECUTIVE DR",
"city": "FAIRVIEW HEIGHTS",
"state": "IL",
"postal_code": "622081345",
"telephone_number": "618-688-4782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEDVED",
"first_name": "ABIGAIL",
"credential": "MA, QMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-10-02",
"last_updated": "2019-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairview Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.