Individual provider Active NPI

Edward Vegliante, LMFT

  • Mental Health Counselor
  • Waterbury, CT
National Provider Identifier
1235473000
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001541 Issued in CT
Practice address
228 Meadow St
Waterbury, CT 06702-1807
Phone
(203) 597-0643
Fax
(203) 597-0834
NPI assigned
Nov 19, 2012
Last updated
Jul 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 33421 CA
Mental Health Counselor 101YM0800X 001541 CT Primary

Addresses

Primary practice location

228 Meadow St
Waterbury, CT 06702-1807

Mailing address

38 Old Ridgebury Rd
Danbury, CT 06810-5128
Phone (203) 792-4515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131002464 CT Practitioner - Mental Health Counselor 3870946312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect CT Medical Foundation IncGroup PAC ID 7416244496, 287 clinicians

Practice addresses (Care Compare)

64 Robbins St
Waterbury, CT 06708-2613
Phone (203) 573-6263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001541CTMDMental Health Counselor
33421CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect CT Medical Foundation, Inc. Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

1801 W Olympic Blvd
#2201
Pasadena, CA 91199

18 Haynes St
Uppr
Manchester, CT 06040
Phone (860) 649-7557

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1235473000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 OLD RIDGEBURY RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105128",
            "telephone_number": "203-792-4515",
            "fax_number": "203-748-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 MEADOW ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021807",
            "telephone_number": "203-597-0643",
            "fax_number": "203-597-0834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGLIANTE",
        "first_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-19",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "33421",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "001541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.