Individual provider Active NPI

Carrie Marie Scampolino, LPC

  • Professional Counselor
  • Waterbury, CT
National Provider Identifier
1114900065
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
001331 Issued in CT
Practice address
64 Robbins St
Crisis Intervention
Waterbury, CT 06708-2613
Phone
(203) 573-6500
Fax
(203) 573-7007
NPI assigned
Nov 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 001331 CT Primary

Addresses

Primary practice location

64 Robbins St
Crisis Intervention
Waterbury, CT 06708-2613

Mailing address

31 Maria Hotchkiss Rd
Prospect, CT 06712-1311
Phone (203) 758-3780

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
I20240126002921 CT Practitioner - Mental Health Counselor 3870946775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

64 Robbins St
Waterbury, CT 06708-2613
Phone (203) 573-6263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001331CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Therapeutic Pathways Professional Past Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

Organizations & group practices 2

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114900065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 MARIA HOTCHKISS RD",
            "city": "PROSPECT",
            "state": "CT",
            "postal_code": "067121311",
            "telephone_number": "203-758-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "address_2": "CRISIS INTERVENTION",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082613",
            "telephone_number": "203-573-6500",
            "fax_number": "203-573-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAMPOLINO",
        "first_name": "CARRIE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.