Individual provider Active NPI

Jennifer L. Spreng, LMFT

  • Marriage & Family Therapist
  • Groton, CT
National Provider Identifier
1336214329
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
0000725 Issued in CT
Practice address
52 Bayberry LN
Groton, CT 06340-6002
Phone
(860) 405-0005
Fax
(860) 445-9594
NPI assigned
Nov 22, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 0000725 CT Primary

Addresses

Primary practice location

52 Bayberry LN
Groton, CT 06340-6002

Mailing address

52 Bayberry LN
Groton, CT 06340-6002
Phone (860) 405-0005

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
I20240717003136 CT Practitioner - Marriage and Family Therapist 8022553775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

100 Fort Hill Rd
Groton, CT 06340-4312
Phone (860) 405-0005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000725CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Counseling LLC CurrentSince Apr 25, 2024 Accepting new patients

Locations

1041 Poquonnock Rd
Groton, CT 06340
Phone (860) 373-4148

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336214329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 BAYBERRY LN",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406002",
            "telephone_number": "860-405-0005",
            "fax_number": "860-445-9594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 BAYBERRY LN",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406002",
            "telephone_number": "860-405-0005",
            "fax_number": "860-445-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRENG",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "0000725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

Verify at the official NPI Registry.