Alyssa Marie Tedesco, LMFT
Individual provider Active NPI Marriage & Family Therapist · Plantsville, CT
NPI 1104488121 · NPPES record last updated Jan 12, 2024
Key facts
- NPI
- 1104488121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 002502 (CT)
- Practice address
- 341 West St Unit B
Plantsville, CT 06479-1140 - Phone
- (203) 718-3121
- Fax
- (203) 756-2521
- NPI assigned
- Jun 29, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Optum Behavioral Care of Connecticut PC
Practice addresses (Care Compare)
341 W St
Unit B
Plantsville, CT 06479-1140
Phone (203) 819-0789
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250527001042 | CT | Practitioner - Marriage and Family Therapist | 1850810524 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002502 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Optum Behavioral Care of Connecticut, P.C. | Current |
Accepting new patients | |
| Optum Behavioral Care of Connecticut, P.C. | Current |
Accepting new patients | |
| Community Guidance Clinic for Central Connecticut, Inc | Past | Accepting new patients | |
| Community Guidance Clinic for Central Connecticut, Inc | Past |
Accepting new patients | |
| Mindscapes Counseling PLLC | Past | Accepting new patients |
Locations
169 Main St
Fl 3
Middletown, CT 06457
Phone (610) 618-6247
200 W Town St
Norwich, CT 06360
Phone (860) 886-1508
Interoperability endpoints
- alyssa.sola.p1@direct.wheelerclinic.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 002502 | CT | Yes |
| Marriage & Family Therapist | 106H00000X |
Addresses
Primary practice location
341 West St Unit B
Plantsville, CT 06479-1140
Mailing address
341 West St Unit B
Plantsville, CT 06479-1140
Phone (203) 718-3121
Other providers in Plantsville, CT
- Ayelet Stein
- Summit at Plantsville Acquisition Operator LLC
- Sunrise Family Medicine LLC
- Elizabeth Suzio
- Patricia Tardif
- Teletherapy Services PLLC
- Melissa Testa
- The Nurse Network, LLC
- Carolyn Ann Thomas
- Shannon Thomas
All providers in Plantsville, CT · Marriage & Family Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.