Rebecca Colella Demaida, LPCA

Individual provider Active NPI Mental Health Counselor · Wolcott, CT

NPI 1184497273 · NPPES record last updated Dec 5, 2023

Key facts

NPI
1184497273
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
6906 (CT)
Practice address
1089B Woodtick Rd
Wolcott, CT 06716-2123
Phone
(203) 879-9485
NPI assigned
Nov 1, 2023
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1089 B Woodtick Rd
Wolcott, CT 06716-2123

53 Muir Ave
Bristol, CT 06010-7215

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260330003850 CT Practitioner - Mental Health Counselor 5991280703 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
6906CTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling Center of Central CT Inc Current
since Mar 26, 2024
Accepting new patients

Locations

1089B Woodtick Rd
Wolcott, CT 06716
Phone (203) 879-9485

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6906 CT Yes

Addresses

Primary practice location

1089B Woodtick Rd
Wolcott, CT 06716-2123

Mailing address

67 North St
Wolcott, CT 06716-1317
Phone (203) 508-5353

Other providers in Wolcott, CT

All providers in Wolcott, CT · Mental Health Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.