Individual provider Active NPI

Carol Lynn Berran, LMFT

  • Marriage & Family Therapist
  • Bethel, CT
National Provider Identifier
1093882508
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
SA-0215 Issued in CT
Practice address
79 Payne Rd
Bethel, CT 06801-1264
Phone
(203) 743-1150
Fax
(203) 743-1105
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001092 CT
Marriage & Family Therapist 106H00000X SA-0215 CT Primary

Addresses

Primary practice location

79 Payne Rd
Bethel, CT 06801-1264

Mailing address

38 Old Ridgebury Rd
Danbury, CT 06810-5128
Phone (203) 743-1150

Other identifiers 3

IdentifierTypeStateIssuer
301090OtherMHN
410001092CT01OtherCTANTHEM BLUE CROSS BLUE SH
004257516MedicaidCT

Other names 1

  • Carol L Berran-Whitman Former name

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
I20240129003031 CT Practitioner - Marriage and Family Therapist 1850744699 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA-0215CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Interface Center Inc Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
Interface Counseling, PLLC CurrentSince Jan 1, 2024 Accepting new patients
Christian Counseling Center of Greater Danbury Inc CurrentSince Mar 1, 2024 Accepting new patients

Locations

2 Old New Milford Rd
Ste 2A
Brookfield, CT 06804
Phone (203) 775-3282

46 Danbury Rd
Ste 6
New Milford, CT 06776
Phone (860) 354-1596

Organizations & group practices 3

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1093882508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 OLD RIDGEBURY RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105128",
            "telephone_number": "203-743-1150",
            "fax_number": "203-743-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 PAYNE RD",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011264",
            "telephone_number": "203-743-1150",
            "fax_number": "203-743-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRAN",
        "first_name": "CAROL",
        "middle_name": "LYNN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001092",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "SA-0215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "301090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "410001092CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004257516",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "BERRAN-WHITMAN",
            "middle_name": "L",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethel, CT

Sources for this page

Verify at the official NPI Registry.