Brandy Marie Sellitto-Taylor, LPC

Individual provider Active NPI Professional Counselor · Thomaston, CT

NPI 1326714031 · NPPES record last updated Sep 6, 2023

Key facts

NPI
1326714031
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
5089 (CT)
Practice address
486 S Main St BLDG 2
Thomaston, CT 06787-1844
Phone
(860) 387-5587
NPI assigned
Aug 22, 2021
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

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

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
5089CTMDProfessional Counselor
6336CTMDAdult Health Nurse Practitioner

Practice roles

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

Specialties & licenses

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

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

Other providers in Thomaston, CT

All providers in Thomaston, CT · Professional Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.