Individual provider Active NPI

Joanna Grace Szymanski

  • Professional Counselor
  • Waterbury, CT
National Provider Identifier
1275008575
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3563 Issued in CT
Practice address
1 Carriage PL
Waterbury, CT 06702-2108
Phone
(860) 805-2267
NPI assigned
Oct 12, 2018
Last updated
Oct 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3563 CT Primary

Addresses

Primary practice location

1 Carriage PL
Waterbury, CT 06702-2108

Mailing address

156 Deer Run
Burlington, CT 06013-1828
Phone (860) 805-5830

Other identifiers 1

IdentifierTypeStateIssuer
14347442OtherCAQH

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3563CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Dialogue LLC Professional CurrentSince Jul 12, 2020 Accepting new patients
Authentic Recovery, LLC Professional Past Accepting new patients

Organizations & group practices 2

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": "1539302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1275008575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 DEER RUN",
            "city": "BURLINGTON",
            "state": "CT",
            "postal_code": "060131828",
            "telephone_number": "860-805-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CARRIAGE PL",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022108",
            "telephone_number": "860-805-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SZYMANSKI",
        "first_name": "JOANNA",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-12",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14347442",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.

Verify at the official NPI Registry.