Individual provider Active NPI

Amy Beth Vales, LMFT

  • Marriage & Family Therapist
  • Monroe, CT
National Provider Identifier
1184102469
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001980 Issued in CT
Practice address
731 Main St Ste 122
Monroe, CT 06468-2872
Phone
(203) 261-7090
NPI assigned
Jul 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001980 CT Primary

Addresses

Primary practice location

731 Main St Ste 122
Monroe, CT 06468-2872

Mailing address

44 Old Sawmill Rd
Trumbull, CT 06611-3355
Phone (203) 981-8489

Other names 1

  • Amy Beth Fullerton Former name

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

LicenseStateTypeSpecialty
001980CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Key Therapy LLC Marriage & Family Therapist PastSince Jul 15, 2018 Accepting new patients

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": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1184102469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 OLD SAWMILL RD",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066113355",
            "telephone_number": "203-981-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 MAIN ST STE 122",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682872",
            "telephone_number": "203-261-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALES",
        "first_name": "AMY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FULLERTON",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Monroe, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; 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.