Stephanie M Antonellis, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

458 Grand Ave
New Haven, CT 06513-3856

Phone

(203) 752-1212

NPI assigned

Jan 11, 2019

Sex

Female

Sole proprietor

No

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.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment NPD CT
• Wheeler Clinic

  • Case Management Agency
  • New Haven, CT
  • NPI 1700320629
  NPD (past)

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.antonellis.p1@direct.wheelerclinic.nextgenshare.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 11, 2019.

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1346714482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 QUARTER MILE RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064771534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "458 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133856",
            "telephone_number": "203-752-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONELLIS",
        "first_name": "STEPHANIE",
        "middle_name": "M",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-11",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily B Ansell, PH.D.
• Richard J Antaya, MD
• Kristine Anthis, PHD
• Danielle Elyse Antin-Ozerkis, MD
• Amanda Antonelli
• David Antonetti, M.D.
• Ashley Antonucci, DNP- FNP
• Michael Jacob Antony, MD
• Sible Antony, M.D.
• Vijay Mariadas Antony, M.D.

• All providers in New Haven, CT
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.