Active NPI
Gianfranco Beaumont, MA, MFT 3314
- Marriage & Family Therapist
- Fairfield, CT
National Provider Identifier
1053960740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 3314
- Practice address
- 1345 Fence Row Dr # 1345
Fairfield, CT 06824-7006 - Phone
- (203) 873-7058
- NPI assigned
- Sep 5, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 3314 | CT | Primary |
Addresses
Primary practice location
1345 Fence Row Dr # 1345
Fairfield, CT 06824-7006
Mailing address
25876 The Old Rd # 86
Stevenson Ranch, CA 91381-1711
Phone (818) 647-2988
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3314 | CT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1053960740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25876 THE OLD RD # 86",
"city": "STEVENSON RANCH",
"state": "CA",
"postal_code": "913811711",
"telephone_number": "818-647-2988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 FENCE ROW DR # 1345",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068247006",
"telephone_number": "203-873-7058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEAUMONT",
"first_name": "GIANFRANCO",
"credential": "MA, MFT 3314",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-05",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "3314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.