Individual provider Active NPI

Brandy Marie Sellitto-Taylor, LPC

  • Professional Counselor
  • Thomaston, CT
National Provider Identifier
1326714031
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5089 Issued in CT
Practice address
486 S Main St BLDG 2
Thomaston, CT 06787-1844
Phone
(860) 387-5587
NPI assigned
Aug 22, 2021
Last updated
Sep 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5089 CT Primary

Addresses

Primary practice location

486 S Main St BLDG 2
Thomaston, CT 06787-1844

Mailing address

60 Lexington Ave
Torrington, CT 06790-3430
Phone (860) 387-5587

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
I20240214003878 CT Practitioner - Mental Health Counselor 1850735184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

486 S Main St
BLDG 2
Thomaston, CT 06787-1844
Phone (860) 387-5587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5089CTMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lagom Lifestyle Counseling LLC Professional CurrentSince Jan 1, 2024 Accepting new patients

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, 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": "1629590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1326714031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 LEXINGTON AVE",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067903430",
            "telephone_number": "860-387-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "486 S MAIN ST BLDG 2",
            "city": "THOMASTON",
            "state": "CT",
            "postal_code": "067871844",
            "telephone_number": "860-387-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLITTO-TAYLOR",
        "first_name": "BRANDY",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-22",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "5089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomaston, CT

Sources for this page

Verify at the official NPI Registry.