Active NPI
Theresa Rose Manolitsis
- Behavior Analyst
- Farmington, CT
National Provider Identifier
1013439488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 17 Talcott Notch Rd
Farmington, CT 06032-1818 - Phone
- (860) 404-6360
- NPI assigned
- Jul 7, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Behavior Analyst | 103K00000X | CT | Primary |
Addresses
Primary practice location
17 Talcott Notch Rd
Farmington, CT 06032-1818
Mailing address
170 Pondview LN
Bristol, CT 06010-3085
Other practice location 1
170 Pondview Lane
Bristol, CT 06010
Phone (860) 490-2283
Other practice location 2
144 Main St Ste G
East Hartford, CT 06118-3239
Phone (888) 754-0398
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| XGC0246M50200 | Other | CT | ANTHEM BLUE CROSS/BLUE SHIELD |
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": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688688000000",
"number": "1013439488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 PONDVIEW LN",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060103085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 TALCOTT NOTCH RD",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060321818",
"telephone_number": "860-404-6360"
}
],
"practiceLocations": [
{
"address_1": "170 Pondview Lane",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "CT",
"postal_code": "06010",
"country_code": "US",
"telephone_number": "860-490-2283",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "144 Main St Ste G",
"address_purpose": "LOCATION",
"city": "East Hartford",
"state": "CT",
"postal_code": "061183239",
"country_code": "US",
"telephone_number": "888-754-0398",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANOLITSIS",
"first_name": "THERESA",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-07",
"last_updated": "2023-07-07",
"certification_date": "2023-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "CT",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS/BLUE SHIELD",
"identifier": "XGC0246M50200",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.