Active NPI
Maryellen T Estrada, LADC
- Addiction (Substance Use Disorder) Counselor
- Stamford, CT
National Provider Identifier
1366190969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 001332
- Practice address
- 240 Wardwell St Apt 24
Stamford, CT 06902-5241 - Phone
- (203) 962-4929
- NPI assigned
- Mar 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 001332 | CT | Primary |
Addresses
Primary practice location
240 Wardwell St Apt 24
Stamford, CT 06902-5241
Mailing address
240 Wardwell St Apt 24
Stamford, CT 06902-5241
Phone (203) 962-4929
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001332 | CT | MD | Women's Health Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647129600000",
"number": "1366190969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 WARDWELL ST APT 24",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069025241",
"telephone_number": "203-962-4929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 WARDWELL ST APT 24",
"city": "STAMFORD",
"state": "CT",
"postal_code": "069025241",
"telephone_number": "203-962-4929"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "MARYELLEN",
"middle_name": "T",
"name_prefix": "Mrs.",
"credential": "LADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-13",
"last_updated": "2022-03-13",
"certification_date": "2022-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "001332",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stamford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.