Active NPI
Melissa Katherine Kish
- Professional Counselor
- Middletown, CT
National Provider Identifier
1245706936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 003475
- Practice address
- 51 Broad St
Middletown, CT 06457-3204 - Phone
- (860) 358-3425
- NPI assigned
- Oct 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 003475 | CT | Primary |
Addresses
Primary practice location
51 Broad St
Middletown, CT 06457-3204
Mailing address
37 Champlin Rd
Killingworth, CT 06419-1358
Phone (860) 575-4917
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003475 | CT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539907200000",
"number": "1245706936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37 CHAMPLIN RD",
"city": "KILLINGWORTH",
"state": "CT",
"postal_code": "064191358",
"telephone_number": "860-575-4917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 BROAD ST",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064573204",
"telephone_number": "860-358-3425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISH",
"first_name": "MELISSA",
"middle_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-19",
"last_updated": "2018-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "003475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.