Individual provider Active NPI

Larissa Sue Cabral

  • Marriage & Family Therapist
  • Windsor, CT
National Provider Identifier
1063757409
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001421 Issued in CT
Practice address
41 Mechanic St
Windsor, CT 06095-2545
Phone
(860) 246-7999
Fax
(860) 688-0004
NPI assigned
Dec 11, 2012
Last updated
Dec 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001421 CT Primary

Addresses

Primary practice location

41 Mechanic St
Windsor, CT 06095-2545

Mailing address

30 Maple Ave
Windsor, CT 06095-2922
Phone (860) 246-7999

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
001421CTMDRegistered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1063757409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MAPLE AVE",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952922",
            "telephone_number": "860-246-7999",
            "fax_number": "860-688-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MECHANIC ST",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952545",
            "telephone_number": "860-246-7999",
            "fax_number": "860-688-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABRAL",
        "first_name": "LARISSA",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.