Individual provider Active NPI

Sooyeon Lee-Garland, LMFT

  • Marriage & Family Therapist
  • Southport, CT
National Provider Identifier
1306864244
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001100 Issued in CT
Practice address
2425 Post Rd Ste 206
Southport, CT 06890-1267
Phone
(203) 685-3015
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001100 CT Primary

Addresses

Primary practice location

2425 Post Rd Ste 206
Southport, CT 06890-1267

Mailing address

20 Sampson Ter
Danbury, CT 06810-5137
Phone (203) 685-3015

Other practice location 1

16 S 9th St
New Hyde Park, NY 11040-4855
Phone (203) 685-3015

Other practice location 2

30 Glenn St Ste 205
White Plains, NY 10603-3252
Phone (203) 685-3015

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20240605000378 NY Practitioner - Marriage and Family Therapist 4981146016 Practice locations: White Plains, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001100CTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1306864244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 SAMPSON TER",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105137",
            "telephone_number": "203-685-3015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 POST RD STE 206",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901267",
            "telephone_number": "203-685-3015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 S 9th St",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110404855",
            "country_code": "US",
            "telephone_number": "203-685-3015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 Glenn St Ste 205",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106033252",
            "country_code": "US",
            "telephone_number": "203-685-3015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE-GARLAND",
        "first_name": "SOOYEON",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, CT

Sources for this page

Verify at the official NPI Registry.