Individual provider Active NPI

Pamela Elizabeth Rosa, LPC

  • Professional Counselor
  • Waterbury, CT
National Provider Identifier
1447403225
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
002328 Issued in CT
Practice address
141 East Main Street
Waterbury, CT 06702-3098
Phone
(203) 574-9000
Fax
(203) 759-5610
NPI assigned
Oct 24, 2008
Last updated
May 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2013

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 002328 CT Primary

Addresses

Primary practice location

141 East Main Street
Waterbury, CT 06702-3098

Mailing address

141 East Main Street
Waterbury, CT 06702-3098
Phone (203) 574-9000

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
I20260602001546 CT Practitioner - Mental Health Counselor 0648741579 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

900 Straits Tpke
Suite 203a
Middlebury, CT 06762-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002328CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mindscapes Counseling PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pamela.rosa.1@28623.direct.athenahealth.com

Organizations & group practices 2

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": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1447403225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 EAST MAIN STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067023098",
            "telephone_number": "203-574-9000",
            "fax_number": "203-759-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 EAST MAIN STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067023098",
            "telephone_number": "203-574-9000",
            "fax_number": "203-759-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "PAMELA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.