Active NPI
Christie Ippolito, MA, LPCA
- Mental Health Counselor
- Ridgefield, CT
National Provider Identifier
1124895289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6096
- Practice address
- 415 Main St
Ridgefield, CT 06877-4500 - Phone
- (475) 302-1143
- NPI assigned
- Dec 8, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6096 | CT | Primary |
Addresses
Primary practice location
415 Main St
Ridgefield, CT 06877-4500
Mailing address
51 Old Mill Rd
Fairfield, CT 06824-4925
Phone (203) 906-8003
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6096 | CT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701993600000",
"number": "1124895289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 OLD MILL RD",
"city": "FAIRFIELD",
"state": "CT",
"postal_code": "068244925",
"telephone_number": "203-906-8003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 MAIN ST",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068774500",
"telephone_number": "475-302-1143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IPPOLITO",
"first_name": "CHRISTIE",
"credential": "MA, LPCA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-08",
"last_updated": "2023-12-08",
"certification_date": "2023-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "6096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgefield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.