Mary Tess Hannafin, MA, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4267 Issued in CT

Practice address

141 Durham Rd Ste 19
Madison, CT 06443-2657

Phone

(203) 479-0235

NPI assigned

Feb 24, 2020

Last updated

Sep 29, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ebb & Flow Creative Psychotherapy, LLC

  • Professional Counselor
  • Branford, CT
  • NPI 1770207060

  Mental Health

  NPD

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1124652748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 DURHAM RD STE 19",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432657",
            "telephone_number": "203-479-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 DURHAM RD STE 19",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064432657",
            "telephone_number": "203-479-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAFIN",
        "first_name": "MARY",
        "middle_name": "TESS",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "4267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia Ramona Guidone, D.P.M.
• Jessica Gurfein Miller
• Giselle Hagen, PHARM. D
• Cynthia Hamlin, APRN, FNP-BC
• Amy J Handzel Kobelia
• Hannah Jurewicz PSYD LLC
• Harborside Connecticut Limited Partnership (Madison House)
• Melissa A Hartmann, LCSW
• Claudette B Hauck, LCSW
• Kevin Healy, DC

• Mental Health Counselor in Madison, CT
• Providers in Madison, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.