Mary Ellen Staudt Spitzfaden, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003152 Issued in CT

Practice address

21 Bridge SQ
Westport, CT 06880-5900

Phone

(203) 554-4091

NPI assigned

Apr 3, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Mary Ellen Staudt, LLC

  • Professional Counselor
  • Westport, CT
  • NPI 1245751155
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1013449586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 BRIDGE SQ",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805900",
            "telephone_number": "203-554-4091",
            "fax_number": "203-554-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BRIDGE SQ",
            "city": "WESTPORT",
            "state": "CT",
            "postal_code": "068805900",
            "telephone_number": "203-554-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUDT SPITZFADEN",
        "first_name": "MARY ELLEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-03",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004066985",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Westport, CT
• Providers in Westport, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.