Susan E. Consoli, MA, LPC
Individual provider Active NPI Professional Counselor · Old Saybrook, CT
NPI 1326337015 · NPPES record last updated Apr 4, 2011
Key facts
- NPI
- 1326337015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 002036 (CT)
- Practice address
- 823 Boston Post Rd
Suite 4
Old Saybrook, CT 06475-2100 - Phone
- (860) 575-8810
- NPI assigned
- Apr 4, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250701002951 | CT | Practitioner - Mental Health Counselor | 6800309030 | Practice locations: East Lyme, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002036 | CT | MD | Professional Counselor |
| 2036 | CT | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Susan Consoli | Professional | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002036 | CT | Yes |
Addresses
Primary practice location
823 Boston Post Rd
Suite 4
Old Saybrook, CT 06475-2100
Mailing address
823 Boston Post Rd
Suite 4
Old Saybrook, CT 06475-2100
Other providers in Old Saybrook, CT
- Christopher S. Connaughty
- Connecticut CVS Pharmacy LLC
- Connecticut River Area Health District
- Lauren Connelly
- Ewa Conroy
- Marylou Cowles
- Craig E McKnight MD PHD LLC
- Craig S. Wilson, D.D.S., LLC
- Laura Craven
- Nicole Chantel Crochetiere
All providers in Old Saybrook, CT · Professional Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.