Amy Sedgwick, LADC, CCDP, SCPG

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0862 Issued in CT

Practice address

62 Carter Rd
Kent, CT 06757-0675

Phone

(860) 927-3772

Fax

(860) 927-1840

NPI assigned

Jan 28, 2010

Last updated

Mar 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Sep 28, 2024 through Sep 28, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Amy Sedgwick Counseling LLC

  • Addiction (Substance Use Disorder) Counselor
  • Thomaston, CT
  • NPI 1679220842
  NPD Authorized official
• High Watch Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Kent, CT
  • NPI 1275946881
  NPD (past)
• Medop Behavioral Health Associates PC

  • Neurology Physician
  • Old Lyme, CT
  • NPI 1053360677
  NPD (past)

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

{
    "created_epoch": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1184955304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CARTER ROAD",
            "city": "KENT",
            "state": "CT",
            "postal_code": "06757",
            "telephone_number": "860-927-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CARTER RD",
            "city": "KENT",
            "state": "CT",
            "postal_code": "067570675",
            "telephone_number": "860-927-3772",
            "fax_number": "860-927-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDGWICK",
        "first_name": "AMY",
        "credential": "LADC, CCDP, SCPG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-28",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "SA- 0215",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "0862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004123840",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004257516",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008017939",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008031626",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Marie Piazza, LMSW
• Dana Marie Pollack, LCSW
• Frank Joseph Ripperger III, PTA
• Alison Rosa, LCSW
• Elizabeth Russ
• Mary E. Smith Bowen, LPN
• Robert H. Stack, R.PH..
• Shannon Strong, LMT
• The Kent LTD.
• The Kent, LTD.

• Addiction (Substance Use Disorder) Counselor in Kent, CT
• Providers in Kent, CT by specialty
• Addiction (Substance Use Disorder) Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.