Active NPI
Peter C Laczak, LMFT
- Marriage & Family Therapist
- Torrington, CT
National Provider Identifier
1396008108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001843
- Practice address
- 540 Litchfield St
C/O Rosa Pagano
Torrington, CT 06790-6679 - Phone
- (860) 496-6361
- Fax
- (860) 496-6389
- NPI assigned
- Jun 18, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001843 | CT | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | CT |
Addresses
Primary practice location
540 Litchfield St
C/O Rosa Pagano
Torrington, CT 06790-6679
Mailing address
540 Litchfield St
C/O Rosa Pagano
Torrington, CT 06790-6679
Phone (860) 496-6361
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 |
|---|---|---|---|
| 001843 | CT | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Sky Counseling LLC | Current | Accepting new patients |
Organizations & group practices 1
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.
-
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- Collinsville, CT
- NPI 1518529775
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479772800000",
"number": "1396008108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 LITCHFIELD ST",
"address_2": "C/O ROSA PAGANO",
"city": "TORRINGTON",
"state": "CT",
"postal_code": "067906679",
"telephone_number": "860-496-6361",
"fax_number": "860-496-6389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "540 LITCHFIELD ST",
"address_2": "C/O ROSA PAGANO",
"city": "TORRINGTON",
"state": "CT",
"postal_code": "067906679",
"telephone_number": "860-496-6361",
"fax_number": "860-496-6389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACZAK",
"first_name": "PETER",
"middle_name": "C",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-18",
"last_updated": "2016-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "001843",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CT",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Torrington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.