Individual provider Active NPI

Emily Velidow

  • Professional Counselor
  • Norwich, CT
National Provider Identifier
1467180679
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
4 Broadway
Norwich, CT 06360-5744
Phone
(860) 425-5258
NPI assigned
Aug 15, 2022
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

4 Broadway
Norwich, CT 06360-5744

Mailing address

4 Broadway
Norwich, CT 06360-5744

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
I20240628000561 CT Practitioner - Mental Health Counselor 1456793298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Connection Inc.Group PAC ID 7719025915, 5 clinicians

Practice addresses (Care Compare)

282 Dwight St
New Haven, CT 06511-3233
Phone (203) 777-3216

4 Broadway
Norwich, CT 06360-5744
Phone (860) 425-5258

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7191CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Connection Inc. CurrentSince Apr 16, 2024 Accepting new patients
The Connection Inc. Current Accepting new patients
The Connection Inc. Past Accepting new patients

Locations

100 Roscommon Dr
Ste 203
Middletown, CT 06457
Phone (860) 343-5500

282 Dwight St
New Haven, CT 06511
Phone (203) 777-3216

4 Broadway
Norwich, CT 06360
Phone (860) 423-5258

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1467180679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BROADWAY",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BROADWAY",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605744",
            "telephone_number": "860-425-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELIDOW",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.