Lucy Kaitlyn Faulkner, MA

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4269 Issued in CT

Practice address

17A Woodland Rd
Madison, CT 06443-2342

Phone

(203) 779-5490

NPI assigned

Oct 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Shoreline Psychological

  • Clinical Psychologist
  • Madison, CT
  • NPI 1750927802
  NPD

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1063011393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WOODLAND RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432342",
            "telephone_number": "203-430-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17A WOODLAND RD",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432342",
            "telephone_number": "203-779-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULKNER",
        "first_name": "LUCY",
        "middle_name": "KAITLYN",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "4269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estela Lopez LCSW LLC
• Harry M Eudowe, DDS
• Jordan Faigen
• Connie Richer Fanelli, PH.D.
• Katherine Elizabeth Farnsworth, PA-C
• John Vincent Federico, M.D.
• Heather Feiner, ATC/LAT
• Kristine Fernerud, LPCA
• Sarah Kate Ferrigno
• Sandra Elaine Ferrucci, LCSW

• Professional Counselor in Madison, CT
• Providers in Madison, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.