Active NPI
Frederick Streets
- Pastoral Counselor
- Stratford, CT
National Provider Identifier
1003459389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 002270
- Practice address
- 602 Nichols Ave
Stratford, CT 06614-3925 - Phone
- (203) 296-2430
- NPI assigned
- Oct 19, 2019
- Last updated
- Oct 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 002270 | CT | Primary |
Addresses
Primary practice location
602 Nichols Ave
Stratford, CT 06614-3925
Mailing address
602 Nichols Ave
Stratford, CT 06614-3925
Phone (203) 296-2430
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002270 | CT | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571443200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571443200000",
"number": "1003459389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "602 NICHOLS AVE",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066143925",
"telephone_number": "203-296-2430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "602 NICHOLS AVE",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066143925",
"telephone_number": "203-296-2430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STREETS",
"first_name": "FREDERICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-19",
"last_updated": "2019-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Pastoral",
"state": "CT",
"license": "002270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stratford, CT
- Stratford Orthodontics
- Stratford Pediatric Associates, P.C.
- Stratford Pediatrics, Inc.
- Stratford Smiles, PLLC
- Stratford Visiting Nurse Association, Inc.
- Sunset Shores of Milford, Inc.
- Supreme Physical Therapy and Wellness Rehabilitation Center
- Bruce John Swearingen Jr., MD
- Sweven Care LLC
- Synergy Rehab OT LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.