Active NPI
Elizabeth Bullard
- Professional Counselor
- Waterbury, CT
National Provider Identifier
1144817537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 5123
- Practice address
- 255 Bank St
Waterbury, CT 06702-2219 - Phone
- (860) 414-2922
- Fax
- (203) 759-0566
- NPI assigned
- Dec 31, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 4383 | CT | |
| Professional Counselor | 101YP2500X | 5123 | CT | Primary |
Addresses
Primary practice location
255 Bank St
Waterbury, CT 06702-2219
Mailing address
29 Albion St
Waterbury, CT 06705-1946
Phone (203) 528-8909
Other practice location 1
29 Albion St
Waterbury, CT 06705-1946
Phone (203) 441-1256
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1144817537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 ALBION ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067051946",
"telephone_number": "203-528-8909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 BANK ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022219",
"telephone_number": "860-414-2922",
"fax_number": "203-759-0566"
}
],
"practiceLocations": [
{
"address_1": "29 Albion St",
"address_purpose": "LOCATION",
"city": "Waterbury",
"state": "CT",
"postal_code": "067051946",
"country_code": "US",
"telephone_number": "203-441-1256",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BULLARD",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-31",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CT",
"license": "4383",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "5123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.