Carol Reilly LCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001659 Issued in CT

Legal business name

CAROL REILLY LCC

Practice address

101 Chestnut St Apt H
Bethel, CT 06801-2660

Phone

(203) 743-6117

NPI assigned

Oct 19, 2013

Organization subpart

No

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

Authorized official

Name

Carol Reilly, LPC

Title

Counselor

Phone

(203) 743-6117

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1382140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382140800000",
    "number": "1134557689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CHESTNUT ST APT H",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012660",
            "telephone_number": "203-743-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHESTNUT ST APT H",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068012660",
            "telephone_number": "203-743-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROL REILLY LCC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-19",
        "last_updated": "2013-10-19",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "203-743-6117",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Bethel, CT
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2013; 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.