NPIMap

Organization Active NPI

Clementine Counseling

  • Professional Counselor
  • West Hartford, CT
National Provider Identifier
1205525524
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
CLEMENTINE COUNSELING
Practice address
784 Farmington Ave
West Hartford, CT 06119-1619
Phone
(860) 245-9077
NPI assigned
May 3, 2023
Last updated
May 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Dr. Kathryn L Henderson, PHD, LPC, NCCNPI 1336715127
Title
Licensed Professional Counselor
Phone
(860) 245-9077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X NU Primary

Addresses

Primary practice location

784 Farmington Ave
West Hartford, CT 06119-1619

Mailing address

784 Farmington Ave
West Hartford, CT 06119-1619
Phone (860) 245-9077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241120001451 CT Part B Supplier - Clinic/Group Practice 5092247734 Receives reassigned benefits from 1 practitioner
Practice locations: West Hartford, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1205525524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "784 FARMINGTON AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191619",
            "telephone_number": "860-245-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 FARMINGTON AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191619",
            "telephone_number": "860-245-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMENTINE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "860-245-9077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.