Active NPI
Stanley Chester Kisiel Jr., LMFT
- Marriage & Family Therapist
- Cheshire, CT
National Provider Identifier
1285721696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001187
- Practice address
- 416 Highland Ave
Building B, Suite 6
Cheshire, CT 06410-2527 - Phone
- (860) 595-6363
- Fax
- (860) 426-8661
- NPI assigned
- Oct 6, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001187 | CT | Primary |
Addresses
Primary practice location
416 Highland Ave
Building B, Suite 6
Cheshire, CT 06410-2527
Mailing address
65 High Gate Rd
C4
Newington, CT 06111-5252
Phone (860) 594-8915
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CTGA000438 B000602 | Other | CT | SAGA GRP |
| 004052015 | Medicaid | CT | |
| 77ABH0021CT01 | Other | CT | ANTHEM |
| ANC1482 | Other | CT | OXFORD HEALTH PLANS |
| 269952 | Other | CT | MANAGED HEALTH NETWORK |
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 |
|---|---|---|---|
| 001187 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365033600000",
"number": "1285721696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 HIGH GATE RD",
"address_2": "C4",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061115252",
"telephone_number": "860-594-8915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 HIGHLAND AVE",
"address_2": "BUILDING B, SUITE 6",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064102527",
"telephone_number": "860-595-6363",
"fax_number": "860-426-8661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISIEL",
"first_name": "STANLEY",
"middle_name": "CHESTER",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2013-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "001187",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAGA GRP",
"identifier": "CTGA000438 B000602",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004052015",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "77ABH0021CT01",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLANS",
"identifier": "ANC1482",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "269952",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cheshire, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.