Active NPI
Andrea Dyal Collura, L.P.C.
- Professional Counselor
- Glastonbury, CT
National Provider Identifier
1194058867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1868
- Practice address
- 2934 Main St
Glastonbury, CT 06033-1027 - Phone
- (860) 338-1166
- NPI assigned
- Sep 14, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 1868 | CT | Primary |
Addresses
Primary practice location
2934 Main St
Glastonbury, CT 06033-1027
Mailing address
79 Elm Ridge Dr
Rocky Hill, CT 06067-2049
Phone (860) 338-1166
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 |
|---|---|---|---|
| 1868 | CT | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265846400000",
"number": "1194058867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 ELM RIDGE DR",
"city": "ROCKY HILL",
"state": "CT",
"postal_code": "060672049",
"telephone_number": "860-338-1166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2934 MAIN ST",
"city": "GLASTONBURY",
"state": "CT",
"postal_code": "060331027",
"telephone_number": "860-338-1166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLURA",
"first_name": "ANDREA",
"middle_name": "DYAL",
"name_prefix": "Mrs.",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-14",
"last_updated": "2010-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "1868",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glastonbury, CT
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.