Nicholas Despoelberch, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2729 Issued in CT

Practice address

30 Hazel Terrace
Suite 11
Woodbridge, CT 06525

Phone

(203) 819-7650

NPI assigned

Apr 15, 2015

Last updated

Mar 31, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• TR Counseling & Wellness LLC

  • Mental Health Counselor
  • Woodbridge, CT
  • NPI 1629494232
  NPD (past)

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1235525387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 HAZEL TERRACE",
            "address_2": "SUITE 11",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "06525",
            "telephone_number": "203-819-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 HAZEL TERRACE",
            "address_2": "SUITE 11",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "06525",
            "telephone_number": "203-819-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESPOELBERCH",
        "first_name": "NICHOLAS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DESPOELBERCH MEDICAID",
            "identifier": "008058532",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Dru De Kadt, NATUROPATHIC PHYSICI
• Leanne Anissa Delgado, LPC
• John Delizio, PH.D.
• Michael M Demetriades, PT
• Nicole Marie Derobertis, LCSW
• Daron Dey
• Ava L Diamond, LCSW
• Dianon Systems Inc
• Jennifer Dinallo, LMFT
• Dove Health Medical Supplies LLC

• Professional Counselor in Woodbridge, CT
• Providers in Woodbridge, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.