Jeffrey Ambroise, LPC
Individual provider Active NPI Professional Counselor · Newington, CT
NPI 1326388257 · NPPES record last updated Mar 7, 2016
Key facts
- NPI
- 1326388257
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 002893 (CT)
- Practice address
- 1268 Main St Ste 106
Newington, CT 06111-3043 - Phone
- (203) 952-1900
- Fax
- (860) 785-8925
- NPI assigned
- Mar 1, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1268 Main St
Newington, CT 06111-3038
Phone (860) 785-6777
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 |
|---|---|---|---|---|
| I20250807000166 | CT | Practitioner - Mental Health Counselor | 7911405238 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2893 | CT | MD | Marriage & Family Therapist |
| 002893 | CT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Courage Counseling Center | Current |
Accepting new patients |
Locations
1268 Main St
Ste 106
Newington, CT 06111
Phone (203) 952-1900
1268 Main St
Ste 204
Newington, CT 06111
Phone (860) 216-1100
1268 Main St
Newington, CT 06111
Phone (860) 566-5674
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 002893 | CT | Yes |
Addresses
Primary practice location
1268 Main St Ste 106
Newington, CT 06111-3043
Mailing address
1268 Main St Ste 106
Newington, CT 06111-3043
Phone (203) 952-1900
Other providers in Newington, CT
- Align Your Mind LLC
- Brendan Allen
- Craig Alver
- Always Professional Homecare LLC
- Amanda Tangney, PLLC
- Paolo Amenta
- Amerodental, LLC
- Amky Health CT, LLC
- Christina Amor
- Ampersand Therapy LLC
All providers in Newington, 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 Mar 7, 2016. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.