Individual provider Active NPI

Ian Kovac, LPC, LMHC, MT-BC

  • Mental Health Counselor
  • Branford, CT
National Provider Identifier
1033802160
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6410 Issued in CT
Practice address
14 Sycamore Way
Branford, CT 06405-6551
Phone
(203) 483-2630
NPI assigned
Jun 2, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12552 MA
Music Therapist 225A00000X 12607
Mental Health Counselor 101YM0800X 6410 CT Primary

Addresses

Primary practice location

14 Sycamore Way
Branford, CT 06405-6551

Mailing address

74 Riggs St
Oxford, CT 06478-1208
Phone (203) 305-1580

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
I20240320000514 CT Practitioner - Mental Health Counselor 2668819178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bhcare, Inc.Group PAC ID 5193819308, 33 clinicians

Practice addresses (Care Compare)

14 Sycamore Way
Branford, CT 06405-6551
Phone (203) 483-2630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6410CTMDMental Health Counselor
12552MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bhcare, Inc. CurrentSince Jan 3, 2024 Accepting new patients

Locations

435 E Main St
Ansonia, CT 06401
Phone (203) 736-2601

14 Sycamore Way
Branford, CT 06405
Phone (203) 483-2630

127 Washington Ave
Ste 3
North Haven, CT 06473

127 Washington Ave
Ste 3W
North Haven, CT 06473

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/BHcare/r4/

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1033802160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 RIGGS ST",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781208",
            "telephone_number": "203-305-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 SYCAMORE WAY",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064056551",
            "telephone_number": "203-483-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAC",
        "first_name": "IAN",
        "credential": "LPC, LMHC, MT-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "12552",
            "primary": false
        },
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": null,
            "license": "12607",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "6410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.