Jacqueline Banasiewicz, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3023 Issued in CT

Practice address

45 S Main St
West Hartford, CT 06107-2441

Phone

(860) 414-4245

NPI assigned

Oct 13, 2016

Sex

Female

Sole proprietor

No

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.

• Clear Life Counseling, LLC

  • Professional Counselor
  • West Hartford, CT
  • NPI 1265983191

  Professional

  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 24, 2024 through Sep 24, 2026

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23932/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 15, 2016.

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476489600000",
    "number": "1013467133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 WOOD CREEK RD",
            "city": "BURLINGTON",
            "state": "CT",
            "postal_code": "060131920",
            "telephone_number": "860-395-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 S MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072441",
            "telephone_number": "860-414-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANASIEWICZ",
        "first_name": "JACQUELINE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordon Baker, MA
• Laura Porter Baker, MSW LCSW
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• Balance Therapy Group PLLC
• Robert Alexander Balla, DMD
• Cassidy Bancroft, RDN
• Tapas Bandyopadhyay, MD
• Mary Ellen Baranik, APRN
• Jeremy M Barbagallo, LPC
• Barbara Bennett LMFT, LLC.

• All providers in West Hartford, CT
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.