Active NPI
Alexa Danielle Liberopoulos, OTR/L
- Occupational Therapist
- Manchester, CT
National Provider Identifier
1083265680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5296
- Practice address
- 385 W Center St
Manchester, CT 06040-4797 - Phone
- (860) 646-0129
- NPI assigned
- Sep 25, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 5296 | CT | Primary |
Addresses
Primary practice location
385 W Center St
Manchester, CT 06040-4797
Mailing address
702 Barbara Jean Dr
Enfield, CT 06082-2187
Phone (413) 426-8731
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5296 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569369600000",
"number": "1083265680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "702 BARBARA JEAN DR",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060822187",
"telephone_number": "413-426-8731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "385 W CENTER ST",
"city": "MANCHESTER",
"state": "CT",
"postal_code": "060404797",
"telephone_number": "860-646-0129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBEROPOULOS",
"first_name": "ALEXA",
"middle_name": "DANIELLE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-25",
"last_updated": "2019-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "5296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.