NPIMap

Individual provider Active NPI

Cynthia Jane Cordova, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Lincoln, NE
National Provider Identifier
1972800506
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
690 Issued in NE
Practice address
120 Wedgewood Dr
Lincoln, NE 68510-2431
Phone
(402) 441-3756
Fax
(402) 441-3770
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 690 NE Primary

Addresses

Primary practice location

120 Wedgewood Dr
Lincoln, NE 68510-2431

Mailing address

120 Wedgewood Dr
Lincoln, NE 68510-2431
Phone (402) 441-3756

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

State licenses

LicenseStateTypeSpecialty
690NEMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Monica'S Past Accepting new patients
St. Monica'S Past Accepting new patients

Organizations & group practices 2

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": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1972800506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WEDGEWOOD DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102431",
            "telephone_number": "402-441-3756",
            "fax_number": "402-441-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WEDGEWOOD DR",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685102431",
            "telephone_number": "402-441-3756",
            "fax_number": "402-441-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "CYNTHIA",
        "middle_name": "JANE",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NE",
            "license": "690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.