Individual provider Active NPI

Judit B Bodo-Maros, LMFT CHT MA

  • Marriage & Family Therapist
  • South Windsor, CT
National Provider Identifier
1124201736
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000627 Issued in CT
Practice address
475 Buckland Street
South Windsor, CT 06074
Phone
(860) 644-7685
Fax
(860) 648-1656
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 000627 CT Primary

Addresses

Primary practice location

475 Buckland Street
South Windsor, CT 06074

Mailing address

475 Buckland Street
South Windsor, CT 06074
Phone (860) 644-7685

Other identifiers 1

IdentifierTypeStateIssuer
410000627CT03OtherCTBLUE CROSS BLUE SHIELD CT

Other names 1

  • Yudit Maros Professional name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000627CTMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1124201736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BUCKLAND STREET",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "06074",
            "telephone_number": "860-644-7685",
            "fax_number": "860-648-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BUCKLAND STREET",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "06074",
            "telephone_number": "860-644-7685",
            "fax_number": "860-648-1656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODO-MAROS",
        "first_name": "JUDIT",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "credential": "LMFT CHT MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "000627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD CT",
            "identifier": "410000627CT03",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YUDIT",
            "last_name": "MAROS",
            "credential": "LMFT CHT MA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in South Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.