NPIMap

Organization Active NPI

Sebastian a. Perumbilly PHD

  • Marriage & Family Therapist
  • Branford, CT
National Provider Identifier
1083038087
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1532 Issued in CT
Legal business name
SEBASTIAN A. PERUMBILLY PHD
Practice address
94 N Branford Rd
Branford, CT 06405-2811
Phone
(203) 483-6860
Fax
(203) 483-6861
NPI assigned
Feb 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Authorized official

Name
Sebastian A Perumbilly, LMFT
Title
Owner/LMFT
Phone
(203) 483-6860

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 1532 CT Primary

Addresses

Primary practice location

94 N Branford Rd
Branford, CT 06405-2811

Mailing address

11112 Town Walk Dr
Hamden, CT 06518-3722
Phone (206) 446-8865

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392076800000",
    "number": "1083038087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11112 TOWN WALK DR",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183722",
            "telephone_number": "206-446-8865",
            "fax_number": "203-483-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 N BRANFORD RD",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064052811",
            "telephone_number": "203-483-6860",
            "fax_number": "203-483-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTIAN A. PERUMBILLY PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-02-11",
        "status": "A",
        "authorized_official_last_name": "PERUMBILLY",
        "authorized_official_first_name": "SEBASTIAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/LMFT",
        "authorized_official_telephone_number": "203-483-6860",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.