Active NPI
Shauntel Lucius
- Professional Counselor
- West Hartford, CT
National Provider Identifier
1376289967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 007306
- Practice address
- 430 New Park Ave
West Hartford, CT 06110-1142 - Phone
- (844) 866-8336
- NPI assigned
- May 7, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 37AC00652500 | NJ | |
| Professional Counselor | 101YP2500X | 007306 | CT | Primary |
Addresses
Primary practice location
430 New Park Ave
West Hartford, CT 06110-1142
Mailing address
271 Wainwright St
Newark, NJ 07112-3073
Phone (347) 493-6056
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 |
|---|---|---|---|
| 37AC00652500 | NJ | MD | Mental Health Counselor |
| 007306 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1376289967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "271 WAINWRIGHT ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071123073",
"telephone_number": "347-493-6056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 NEW PARK AVE",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061101142",
"telephone_number": "844-866-8336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCIUS",
"first_name": "SHAUNTEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-07",
"last_updated": "2024-12-02",
"certification_date": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NJ",
"license": "37AC00652500",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "007306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.