Individual provider Active NPI

Amy M St. Pierre, LADC, LPC

  • Professional Counselor
  • Manchester, CT
National Provider Identifier
1063782084
Registry record updated Mar 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4253 Issued in CT
Practice address
71 Haynes St
Manchester, CT 06040-4131
Phone
(860) 646-1222
Fax
(860) 647-6831
NPI assigned
Jan 6, 2012
Last updated
Mar 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000940 CT
Professional Counselor 101YP2500X 4253 CT Primary

Addresses

Primary practice location

71 Haynes St
Manchester, CT 06040-4131

Mailing address

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 646-1222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312001035 CT Practitioner - Mental Health Counselor 8325476245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health Resources, Inc.Group PAC ID 5597652149, 50 clinicians

Practice addresses (Care Compare)

444 Ctr St
Manchester, CT 06040-3926
Phone (860) 646-3888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000940CTMDMarriage & Family Therapist
4253CTMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, Inc. CurrentSince Jan 31, 2024 Accepting new patients
Community Health Resources, Inc CurrentSince Jan 31, 2024 Accepting new patients

Locations

71 Westcott Rd
Danielson, CT 06239
Phone (860) 456-0038

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

444 Center St
Manchester, CT 06040
Phone (860) 646-3888

2 Waterside Xing
Ste 401
Windsor, CT 06095

Interoperability endpoints

  • Direct secure messaging: amy.stpierre.p1@direct.wheelerclinic.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1325808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1063782084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-646-1222",
            "fax_number": "860-647-6831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 HAYNES ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404131",
            "telephone_number": "860-646-1222",
            "fax_number": "860-647-6831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST. PIERRE",
        "first_name": "AMY",
        "middle_name": "M",
        "credential": "LADC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-06",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000940",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "4253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.