Susan Kudrak

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

000637 Issued in CT

Practice address

35 Judd Ave
Bethel, CT 06801-1538

Phone

(203) 733-9103

Fax

(203) 744-0801

NPI assigned

Sep 23, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

WCT Behavioral Health and Medication Management PLLCGroup PAC ID 8820480734, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• WCT Behavioral Health & Medication Management PLLC

  • Family Nurse Practitioner
  • Waterbury, CT
  • NPI 1285391474
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1336790211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 JUDD AVE",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011538",
            "telephone_number": "203-733-9103",
            "fax_number": "203-744-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 JUDD AVE",
            "city": "BETHEL",
            "state": "CT",
            "postal_code": "068011538",
            "telephone_number": "203-733-9103",
            "fax_number": "203-744-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDRAK",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "000637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stanley Harris Kessler, D.D.S.
• Hyeongu Kim, DMD
• Kathleen Kinas, MS, CCC-SLP
• Jonathan B Knapp, D.M.D.
• Alina Kogan, DPM
• Stephania Kataryna Kushnir, APRN
• Ellen Turner Lacko, LCSW
• Lisa N Lagratta
• Tennille Gael Lambert, OTR/L
• Laura Shahinian Kara

• Professional Counselor in Bethel, CT
• Providers in Bethel, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.