Individual provider Active NPI

Mary Elizabeth Davidson-Reed, MA, CRC

  • Professional Counselor
  • Danielson, CT
National Provider Identifier
1477052116
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
245 Main St
Danielson, CT 06239-2816
Phone
(888) 316-5221
Fax
(866) 203-2138
NPI assigned
Feb 8, 2018
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

245 Main St
Danielson, CT 06239-2816

Mailing address

1007 N Main St
Dayville, CT 06241-2170
Phone (860) 774-2020

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
I20240110003792 CT Practitioner - Mental Health Counselor 5698126910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regeneration Therapy and Counseling LLCGroup PAC ID 7719363886, 8 clinicians

Practice addresses (Care Compare)

245 Main St
Danielson, CT 06239-2816
Phone (888) 316-5221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4841CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regeneration Therapy and Counseling LLC Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

245 Main St
Danielson, CT 06239
Phone (401) 935-3824

Organizations & group practices 1

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": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1477052116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 N MAIN ST",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "062412170",
            "telephone_number": "860-774-2020",
            "fax_number": "860-774-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 MAIN ST",
            "city": "DANIELSON",
            "state": "CT",
            "postal_code": "062392816",
            "telephone_number": "888-316-5221",
            "fax_number": "866-203-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON-REED",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "MA, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danielson, CT

Sources for this page

Verify at the official NPI Registry.