Individual provider Active NPI

Maryjane Speranza, LPC

  • Professional Counselor
  • East Haven, CT
National Provider Identifier
1114120276
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
001631 Issued in CT
Practice address
259 Grannis St
East Haven, CT 06512-1504
Phone
(203) 376-8891
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X --1631 CT
Professional Counselor 101YP2500X 001631 CT Primary

Addresses

Primary practice location

259 Grannis St
East Haven, CT 06512-1504

Mailing address

259 Grannis St
East Haven, CT 06512-1504
Phone (203) 376-8891

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
I20240313003537 CT Practitioner - Mental Health Counselor 9830535798 Practice locations: East Haven, CT

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

259 Grannis St
East Haven, CT 06512-1504
Phone (203) 376-8891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
--1631CTMDProfessional Counselor
001631CTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1114120276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 GRANNIS ST",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065121504",
            "telephone_number": "203-376-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 GRANNIS ST",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065121504",
            "telephone_number": "203-376-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERANZA",
        "first_name": "MARYJANE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "--1631",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Haven, CT

Sources for this page

Verify at the official NPI Registry.