Individual provider Active NPI

George E Pipkin III, LPC

  • Professional Counselor
  • New Haven, CT
National Provider Identifier
1326507203
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
003403 Issued in CT
Practice address
109 Legion Ave
New Haven, CT 06519-5506
Phone
(203) 562-2264
Fax
(203) 789-1335
NPI assigned
Mar 19, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 003403 CT Primary

Addresses

Primary practice location

109 Legion Ave
New Haven, CT 06519-5506

Mailing address

109 Legion Ave
New Haven, CT 06519-5506
Phone (203) 562-2264

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
I20240108003624 CT Practitioner - Mental Health Counselor 3072964725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

2400 Main St
Bridgeport, CT 06606-5323
Phone (203) 362-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003403CTMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbeing Counseling Services LLC Professional Current Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jan 1, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists, PLLC Single Specialty CurrentSince Jan 1, 2024 Accepting new patients
SVMC Holdings, Inc Single Specialty Past Accepting new patients

Locations

2400 Main St
Bridgeport, CT 06606
Phone (203) 362-3900

1 Lois St
Norwalk, CT 06851
Phone (203) 221-8893

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1326507203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LEGION AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065195506",
            "telephone_number": "203-562-2264",
            "fax_number": "203-789-1335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 LEGION AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065195506",
            "telephone_number": "203-562-2264",
            "fax_number": "203-789-1335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPKIN",
        "first_name": "GEORGE",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-19",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.