Active NPI
Anna Poltorak
- Mental Health Counselor
- Avon, CT
National Provider Identifier
1083095434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3124
- Practice address
- 40 Avon Meadow LN BLDG 40
Avon, CT 06001-3753 - Phone
- (860) 325-0305
- NPI assigned
- Jun 11, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Mental Health Counselor | 101YM0800X | 3124 | CT | Primary |
Addresses
Primary practice location
40 Avon Meadow LN BLDG 40
Avon, CT 06001-3753
Mailing address
40 Avon Meadow LN
Avon, CT 06001-3753
Phone (860) 325-0305
Other practice location 1
55 Winthrop St
New Britain, CT 06052-1728
Phone (860) 224-8192
Other practice location 2
40 Avon Meadow Ln
Avon, CT 06001-3753
Phone (860) 325-0305
Other names 1
- Ania Poltorak
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harmony Counseling | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602720000000",
"number": "1083095434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 AVON MEADOW LN",
"city": "AVON",
"state": "CT",
"postal_code": "060013753",
"telephone_number": "860-325-0305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 AVON MEADOW LN BLDG 40",
"city": "AVON",
"state": "CT",
"postal_code": "060013753",
"telephone_number": "860-325-0305"
}
],
"practiceLocations": [
{
"address_1": "55 Winthrop St",
"address_purpose": "LOCATION",
"city": "New Britain",
"state": "CT",
"postal_code": "060521728",
"country_code": "US",
"telephone_number": "860-224-8192",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40 Avon Meadow Ln",
"address_purpose": "LOCATION",
"city": "Avon",
"state": "CT",
"postal_code": "060013753",
"country_code": "US",
"telephone_number": "860-325-0305",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLTORAK",
"first_name": "ANNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-11",
"last_updated": "2020-10-15",
"certification_date": "2020-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "3124",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANIA",
"last_name": "POLTORAK",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Avon, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.