Active NPI
Shannon Haluchak, LPC
- Professional Counselor
- Thomaston, CT
National Provider Identifier
1295095768
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 002177
- Practice address
- 185 Branch Rd
Thomaston, CT 06787-1984 - Phone
- (860) 283-3030
- Fax
- (860) 283-3034
- NPI assigned
- May 18, 2012
- Last updated
- Jul 1, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002177 | CT | Primary |
Addresses
Primary practice location
185 Branch Rd
Thomaston, CT 06787-1984
Mailing address
19 Buttercup LN
New Hartford, CT 06057-3601
Phone (203) 910-9843
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 |
|---|---|---|---|
| 002177 | CT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1295095768",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 BUTTERCUP LN",
"city": "NEW HARTFORD",
"state": "CT",
"postal_code": "060573601",
"telephone_number": "203-910-9843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "185 BRANCH RD",
"city": "THOMASTON",
"state": "CT",
"postal_code": "067871984",
"telephone_number": "860-283-3030",
"fax_number": "860-283-3034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALUCHAK",
"first_name": "SHANNON",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-05-18",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "002177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thomaston, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.