Active NPI
Alizae Wineglass, LPC-A
- Mental Health Counselor
- Waterbury, CT
National Provider Identifier
1407513575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 30 Holmes Ave
Waterbury, CT 06710-2412 - Phone
- (203) 707-5588
- NPI assigned
- Nov 23, 2021
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CT | Primary |
Addresses
Primary practice location
30 Holmes Ave
Waterbury, CT 06710-2412
Mailing address
30 Holmes Ave
Waterbury, CT 06710-2412
Phone (203) 707-5588
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8531 | CT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Mental Health | Current | Accepting new patients |
Locations
100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1407513575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 HOLMES AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067102412",
"telephone_number": "203-707-5588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 HOLMES AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067102412",
"telephone_number": "203-707-5588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINEGLASS",
"first_name": "ALIZAE",
"credential": "LPC-A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-11-23",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.