Individual provider Active NPI

Suzanne Champagne McColl, MS,LPC

  • Counselor
  • Branford, CT
National Provider Identifier
1306077326
Registry record updated Aug 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
001436 Issued in CT
Practice address
250 W Main St
Branford, CT 06405-4032
Phone
(203) 804-9448
NPI assigned
Aug 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 001436 CT Primary

Addresses

Primary practice location

250 W Main St
Branford, CT 06405-4032

Mailing address

250 W Main St
Branford, CT 06405-4032
Phone (203) 804-9448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240128000110 CT Practitioner - Mental Health Counselor 0941653794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sound Health and Wellness LLCGroup PAC ID 9032562889, 13 clinicians

Practice addresses (Care Compare)

64 Thompson St
Suite A106
East Haven, CT 06513-5700
Phone (203) 804-9448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
001436CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Health and Wellness LLC CurrentSince Dec 2, 2023 Accepting new patients

Locations

64 Thompson St
Ste A106
East Haven, CT 06513
Phone (203) 691-8163

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249603200000",
    "number": "1306077326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054032",
            "telephone_number": "203-804-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064054032",
            "telephone_number": "203-804-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLL",
        "first_name": "SUZANNE",
        "middle_name": "CHAMPAGNE",
        "name_prefix": "Ms.",
        "credential": "MS,LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-07",
        "last_updated": "2009-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "001436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.