Active NPI
Edicson Orozco, LPC
- Professional Counselor
- Bridgeport, CT
National Provider Identifier
1154870848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 003026
- Practice address
- 475 Clinton Ave
Bridgeport, CT 06605-1700 - Phone
- (203) 368-4291
- Fax
- (203) 368-9167
- NPI assigned
- Sep 23, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 003026 | CT | Primary |
Addresses
Primary practice location
475 Clinton Ave
Bridgeport, CT 06605-1700
Mailing address
475 Clinton Ave
Bridgeport, CT 06605-1700
Phone (203) 368-4291
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004069985 | Medicaid | CT |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003026 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1154870848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 CLINTON AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066051700",
"telephone_number": "203-368-4291",
"fax_number": "203-368-9167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 CLINTON AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066051700",
"telephone_number": "203-368-4291",
"fax_number": "203-368-9167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OROZCO",
"first_name": "EDICSON",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-23",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "003026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004069985",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.