Individual provider Active NPI

Isaiah Darnell Dockett

  • Addiction (Substance Use Disorder) Counselor
  • New Haven, CT
National Provider Identifier
1043924178
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1488 Issued in CT
Practice address
1 Long Wharf Dr Ste 321
New Haven, CT 06511-5946
Phone
(203) 781-4600
Fax
(203) 781-4624
NPI assigned
Jan 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1488 CT Primary

Addresses

Primary practice location

1 Long Wharf Dr Ste 321
New Haven, CT 06511-5946

Mailing address

1 Long Wharf Dr Ste 321
New Haven, CT 06511-5946
Phone (203) 781-4600

Other practice location 1

1423 Chapel St
New Haven, CT 06511-4411
Phone (860) 531-2599

Other identifiers 5

IdentifierTypeStateIssuer
008023170MedicaidCT
008024427MedicaidCT
008115789MedicaidCT
008109605MedicaidCT
008042339MedicaidCT

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
I20240520001949 CT Practitioner - Mental Health Counselor 6305288507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prosperity Counseling LLCGroup PAC ID 4284075565, 3 clinicians

Practice addresses (Care Compare)

1435 Chapel St
Apt 1
New Haven, CT 06511-8603
Phone 2037179900200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prosperity Counseling LLC Addiction (Substance Use Disorder) CurrentSince Mar 23, 2024 Accepting new patients

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1043924178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR STE 321",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115946",
            "telephone_number": "203-781-4600",
            "fax_number": "203-781-4624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR STE 321",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115946",
            "telephone_number": "203-781-4600",
            "fax_number": "203-781-4624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1423 Chapel St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065114411",
            "country_code": "US",
            "telephone_number": "860-531-2599",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOCKETT",
        "first_name": "ISAIAH",
        "middle_name": "DARNELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008023170",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008024427",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008115789",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008109605",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008042339",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.