Active NPI
Kelly Stutzman
- Professional Counselor
- Hamden, CT
National Provider Identifier
1013386705
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Feb 20, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 002106
- Practice address
- 196 Magee Dr
Hamden, CT 06514-1340 - Phone
- (203) 695-3737
- Fax
- (203) 891-7629
- NPI assigned
- Sep 23, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002106 | CT | Primary |
Addresses
Primary practice location
196 Magee Dr
Hamden, CT 06514-1340
Mailing address
196 Magee Dr
Hamden, CT 06514-1340
Phone (203) 695-3737
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002106 | CT | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K-Assist LLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
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": "1442966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442966400000",
"number": "1013386705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "196 MAGEE DR",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065141340",
"telephone_number": "203-695-3737",
"fax_number": "203-891-7629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 MAGEE DR",
"city": "HAMDEN",
"state": "CT",
"postal_code": "065141340",
"telephone_number": "203-695-3737",
"fax_number": "203-891-7629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUTZMAN",
"first_name": "KELLY",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-23",
"last_updated": "2015-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "002106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.