Individual provider Active NPI

Christine Elizabeth Tirado, LPC

  • Professional Counselor
  • New Haven, CT
National Provider Identifier
1427690841
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3836 Issued in CT
Practice address
1 Long Wharf Dr Ste 321
New Haven, CT 06511-5946
Phone
(203) 781-4600
Fax
(203) 781-4624
NPI assigned
Oct 17, 2019
Last updated
Jun 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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 3836 CT Primary

Addresses

Primary practice location

1 Long Wharf Dr Ste 321
New Haven, CT 06511-5946

Mailing address

397 Eastern St Apt F
New Haven, CT 06513-2369
Phone (203) 903-8423

Other practice location 1

3013 Dixwell Ave
Hamden, CT 06518-3527
Phone (203) 399-6071

Other identifiers 4

IdentifierTypeStateIssuer
004041000MedicaidCT
TIRADO-008091555MedicaidCT
008003745MedicaidCT
004217099MedicaidCT

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
I20240126002701 CT Practitioner - Mental Health Counselor 0648623546 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Apt Foundation, Inc CurrentSince Jan 1, 2024 Accepting new patients
Grow Healthcare Group PA Professional CurrentSince Aug 27, 2024 Accepting new patients
Apt Foundation, Inc CurrentSince Jan 1, 2024 Accepting new patients
Resilient Behavioral Health LLC CurrentSince Jul 23, 2023 Accepting new patients

Locations

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

1 Long Wharf Dr
New Haven, CT 06511
Phone (203) 777-7500

1 Long Wharf Dr
Ste 321
New Haven, CT 06511
Phone (203) 781-4600

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1427690841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "397 EASTERN ST APT F",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065132369",
            "telephone_number": "203-903-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR STE 321",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115946",
            "telephone_number": "203-781-4600",
            "fax_number": "203-781-4624"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3013 Dixwell Ave",
            "address_purpose": "LOCATION",
            "city": "Hamden",
            "state": "CT",
            "postal_code": "065183527",
            "country_code": "US",
            "telephone_number": "203-399-6071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIRADO",
        "first_name": "CHRISTINE",
        "middle_name": "ELIZABETH",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004041000",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TIRADO-008091555",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008003745",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004217099",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.