Active NPI
Ethan Drozd, LPC
- Professional Counselor
- West Haven, CT
National Provider Identifier
1275953945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2522
- Practice address
- 184 Front Ave
West Haven, CT 06516-2836 - Phone
- (203) 781-4600
- Fax
- (203) 781-4624
- NPI assigned
- Apr 22, 2014
- Last updated
- Feb 7, 2017
- Sex
- Male
- 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 | 2522 | CT | Primary |
Addresses
Primary practice location
184 Front Ave
West Haven, CT 06516-2836
Mailing address
1 Long Wharf Dr
New Haven, CT 06511-5991
Phone (203) 781-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008050785 | Other | CT | MEDICAID FOR ETHAN DRODZ |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2522 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1275953945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 LONG WHARF DR",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115991",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 FRONT AVE",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065162836",
"telephone_number": "203-781-4600",
"fax_number": "203-781-4624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DROZD",
"first_name": "ETHAN",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-22",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "2522",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID FOR ETHAN DRODZ",
"identifier": "008050785",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.