Active NPI
Julie Alyce Yale, LPC
- Professional Counselor
- Niantic, CT
National Provider Identifier
1053880526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 002490
- Practice address
- 8 W Main St Ste 2-9
Niantic, CT 06357-2331 - Phone
- (860) 304-6073
- NPI assigned
- Nov 14, 2018
- Last updated
- Aug 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002490 | CT | Primary |
Addresses
Primary practice location
8 W Main St Ste 2-9
Niantic, CT 06357-2331
Mailing address
PO Box 433
Niantic, CT 06357-0433
Phone (860) 304-6073
Other names 1
- Julie Alyce Potvin
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002490 | CT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1053880526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 433",
"city": "NIANTIC",
"state": "CT",
"postal_code": "063570433",
"telephone_number": "860-304-6073",
"fax_number": "860-850-1036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 W MAIN ST STE 2-9",
"city": "NIANTIC",
"state": "CT",
"postal_code": "063572331",
"telephone_number": "860-304-6073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YALE",
"first_name": "JULIE",
"middle_name": "ALYCE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-14",
"last_updated": "2024-08-09",
"certification_date": "2024-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "002490",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JULIE",
"last_name": "POTVIN",
"middle_name": "ALYCE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Niantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.