Individual provider Active NPI

Kieran Patrick Maiorana, LPC

  • Professional Counselor
  • New Haven, CT
National Provider Identifier
1336637362
Registry record updated Apr 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
03429 Issued in CT
Practice address
98 York St
New Haven, CT 06511-5602
Phone
(203) 530-5396
Fax
(203) 785-7517
NPI assigned
Apr 25, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2018

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 03429 CT Primary

Addresses

Primary practice location

98 York St
New Haven, CT 06511-5602

Mailing address

98 York St
New Haven, CT 06511-5602
Phone (203) 785-6862

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
I20240124001379 CT Practitioner - Mental Health Counselor 5991158107 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03429CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University CurrentSince Jan 1, 2024 Accepting new patients
Yale University CurrentSince Jan 1, 2024 Accepting new patients
Yale University Past Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

50 Division St
New Haven, CT 06511
Phone (203) 785-2140

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524614400000",
    "number": "1336637362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115602",
            "telephone_number": "203-785-6862",
            "fax_number": "203-785-7517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 YORK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115602",
            "telephone_number": "203-530-5396",
            "fax_number": "203-785-7517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIORANA",
        "first_name": "KIERAN",
        "middle_name": "PATRICK",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "03429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.