Real Talk CT
Organization Active NPI Counselor · Burlington, CT
NPI 1467948752 · NPPES record last updated May 21, 2024
Key facts
- NPI
- 1467948752
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Counselor 101Y00000X
- License
- 2668 (CT)
- Legal business name
- REAL TALK CT
- Practice address
- 258 Spielman Hwy
Burlington, CT 06013-1723 - Phone
- (860) 325-0579
- NPI assigned
- Jul 10, 2018
- Organization subpart
- No
Authorized official
- Name
- Ryan McGuire, LPC
- Title
- Owner
- Phone
- (860) 729-5988
Practitioners 3
-
Sean Theus, FNP-BC, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250212003314 | CA | Part B Supplier - Clinic/Group Practice | 5395182554 |
Receives reassigned benefits from 3 practitioners Practice locations: Temecula, CA |
National Provider Directory
Locations
258 Spielman Hwy
Ste 11
Burlington, CT 06013
Phone (959) 210-6800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor |
101Y00000X | 2668 | CT | Yes |
Addresses
Primary practice location
258 Spielman Hwy
Burlington, CT 06013-1723
Mailing address
258 Spielman Hwy
Burlington, CT 06013-1723
Phone (860) 325-0579
Other providers in Burlington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.