Individual provider Active NPI

Marcey Jan Rizzetta, LPC

  • Professional Counselor
  • Waterbury, CT
National Provider Identifier
1366696569
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
001714 Issued in CT
Practice address
70 Pine St
Waterbury, CT 06710-2169
Phone
(203) 756-7287
NPI assigned
Nov 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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 001714 CT Primary

Addresses

Primary practice location

70 Pine St
Waterbury, CT 06710-2169

Mailing address

141 E Main St
Waterbury, CT 06702-2310
Phone (203) 574-9000

Other names 1

  • Miss Marcey Jan Spatafore Former name

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
I20240111003689 CT Order and Referring Only - Mental Health Counselor 5092166249

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001714CTMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1366696569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PINE ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067102169",
            "telephone_number": "203-756-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZZETTA",
        "first_name": "MARCEY",
        "middle_name": "JAN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-14",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCEY",
            "last_name": "SPATAFORE",
            "middle_name": "JAN",
            "prefix": "MISS",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.