Timothy M Aquino, LMFT
Individual provider Active NPI Marriage & Family Therapist · Westport, CT
NPI 1194472522 · NPPES record last updated Mar 6, 2022
Key facts
- NPI
- 1194472522
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 002825 (CT)
- Practice address
- 19 Ludlow Rd
Westport, CT 06880-3040 - Phone
- (203) 208-3940
- Fax
- (203) 693-4900
- NPI assigned
- Mar 6, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002825 | CT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Redeem Wellness Center II, LLC | Marriage & Family Therapist | Current |
Accepting new patients |
Locations
19 Ludlow Rd
Ste 302
Westport, CT 06880
Phone (203) 684-0734
19 Ludlow Rd
Westport, CT 06880
Phone (203) 208-3940
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 002825 | CT | Yes |
Addresses
Primary practice location
19 Ludlow Rd
Westport, CT 06880-3040
Mailing address
19 Ludlow Rd
Westport, CT 06880-3040
Phone (203) 208-3940
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008107193 | Medicaid | CT |
Other providers in Westport, CT
- Susan M Amster
- Amy Young LCSW - PLLC
- Catharine Lyndsay Andrews
- Nicole Antaya
- Nina Katherine Antonov
- Ellen Arcamone
- Neha Armstrong
- Nancy Yvonne Arndt
- Stacey Rosenkrantz Aronson
- Niyosha Arthur
All providers in Westport, CT · Marriage & Family Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.