Individual provider Active NPI

Patricia Hennessy, MA

  • Professional Counselor
  • New London, CT
National Provider Identifier
1407449788
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
7 Vauxhall St
New London, CT 06320-5711
Phone
(860) 442-2797
Fax
(860) 701-3776
NPI assigned
Feb 17, 2021
Last updated
Feb 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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 NU Primary

Addresses

Primary practice location

7 Vauxhall St
New London, CT 06320-5711

Mailing address

255 Hempstead St
New London, CT 06320-6290
Phone (860) 443-2896

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
I20240201002781 CT Practitioner - Mental Health Counselor 8921451311 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Agency of Southeastern Connecticut, Inc. Current Accepting new patients
Child and Family Agency of Southeastern Connecticut, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Child and Family Agency of Southeastern Connecticut, Inc. CurrentSince Jan 1, 2024 Accepting new patients

Locations

591 Poquonnock Rd
Groton, CT 06340
Phone (860) 449-8217

255 Hempstead St
New London, CT 06320

7 Vauxhall St
New London, CT 06320
Phone (860) 442-2797

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1407449788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206290",
            "telephone_number": "860-443-2896",
            "fax_number": "860-442-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 VAUXHALL ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205711",
            "telephone_number": "860-442-2797",
            "fax_number": "860-701-3776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "PATRICIA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.