Individual provider Active NPI

Mary Elizabeth Musco, LPC, LMFT

  • Professional Counselor
  • Waterbury, CT
National Provider Identifier
1063510535
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
000344 Issued in CT
Practice address
95 N Main St
Waterbury, CT 06702-1409
Phone
(203) 573-0264
Fax
(203) 755-4835
NPI assigned
Sep 20, 2006
Last updated
Jan 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 000344 CT Primary
Marriage & Family Therapist 106H00000X 001104 CT

Addresses

Primary practice location

95 N Main St
Waterbury, CT 06702-1409

Mailing address

236 Pierremount Ave
New Britain, CT 06053-2366
Phone (860) 826-5987

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

LicenseStateTypeSpecialty
001104CTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1063510535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 PIERREMOUNT AVE",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060532366",
            "telephone_number": "860-826-5987",
            "fax_number": "860-826-5987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 N MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021409",
            "telephone_number": "203-573-0264",
            "fax_number": "203-755-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSCO",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "LPC, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "000344",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.