Stacey Boisselle, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002583 Issued in CT

Practice address

60 Old Town Rd Unit 107
Vernon, CT 06066-6404

Phone

(860) 214-3113

NPI assigned

Oct 28, 2015

Last updated

Oct 28, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445990400000",
    "number": "1467824508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 OLD TOWN RD. UNIT 107",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "06066",
            "telephone_number": "860-214-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 OLD TOWN RD UNIT 107",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060666404",
            "telephone_number": "860-214-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOISSELLE",
        "first_name": "STACEY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allison Blunt
• Vickie Boivin, PHARMD.
• Bolbol LLC (The Medicine Shoppe 1442)
• Erica Yvonne Bower, MS ED. LPC
• John W Bradner, LADC
• Janine Brandt, RPH

• Professional Counselor in Vernon, CT
• Providers in Vernon, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.