Summer Collins
Individual provider Active NPI Counselor · Willimantic, CT
NPI 1235972019 · NPPES record last updated Jun 18, 2024
Key facts
- NPI
- 1235972019
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 7263 (CT)
- Practice address
- 842 Main St
Willimantic, CT 06226-2442 - Phone
- (860) 450-0151
- NPI assigned
- Jun 18, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Change Counseling LLC
Practice addresses (Care Compare)
6 Ledgebrook Dr
Suite C
Mansfield Center, CT 06250-1644
Phone (860) 833-2657
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241219001695 | CT | Practitioner - Mental Health Counselor | 4385183888 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7263 | CT | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Change Counseling, LLC | Current |
Accepting new patients | |
| Perception Programs Inc | Current |
Accepting new patients |
Locations
6 Ledgebrook Dr
Ste C
Mansfield Center, CT 06250
Phone (860) 833-2657
842 Main St
Willimantic, CT 06226
Phone (860) 450-0151
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/perceptionprograms/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 7263 | CT | Yes |
Addresses
Primary practice location
842 Main St
Willimantic, CT 06226-2442
Mailing address
842 Main St
Willimantic, CT 06226-2442
Other names
- Summer Rodriguez
Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.