Individual provider Active NPI

David Eppner

  • Counselor
  • Manchester, CT
National Provider Identifier
1174189443
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
444 Center St
Manchester, CT 06040-3926
Phone
(860) 646-3888
Fax
(860) 645-4132
NPI assigned
May 13, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

444 Center St
Manchester, CT 06040-3926

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1587
Phone (860) 731-5522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220426000355 CT Practitioner - Clinical Social Worker 4385031160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
WCT Behavioral Health and Medication Management PLLCGroup PAC ID 8820480734, 30 clinicians

Practice addresses (Care Compare)

211 Schraffts Dr
Lowr Level
Waterbury, CT 06705-3222
Phone (203) 518-8218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
WCT Behavioral Health & Medication Management PLLC CurrentSince Mar 1, 2022 Accepting new patients

Locations

211 Schraffts Dr
Lowr
Waterbury, CT 06705
Phone (203) 518-8218

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1174189443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951587",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060403926",
            "telephone_number": "860-646-3888",
            "fax_number": "860-645-4132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPPNER",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.