Individual provider Active NPI

Pamela Mulready, LPC, LADC

  • Professional Counselor
  • Middletown, CT
National Provider Identifier
1023373248
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1928 Issued in CT
Practice address
850 Randolph Rd
Middletown, CT 06457-5237
Phone
(860) 975-5573
NPI assigned
Jul 13, 2012
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 001054 CT
Professional Counselor 101YP2500X 1928 CT Primary

Addresses

Primary practice location

850 Randolph Rd
Middletown, CT 06457-5237

Mailing address

850 Randolph Rd
Middletown, CT 06457-5237
Phone (860) 975-5573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715000036 CT Practitioner - Mental Health Counselor 8022553064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1928CTMDAthletic Trainer
001054CTMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: pamela.mulready@xdr.hhchealthdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1023373248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 RANDOLPH RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064575237",
            "telephone_number": "860-975-5573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 RANDOLPH RD",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064575237",
            "telephone_number": "860-975-5573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULREADY",
        "first_name": "PAMELA",
        "credential": "LPC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "001054",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "1928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.