Jill R. Cristo Ma LMFT LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

000717 Issued in CT

Legal business name

JILL R. CRISTO MA LMFT LLC

Practice address

23 Colonial Dr N
Bloomfield, CT 06002-2393

Phone

(860) 463-6723

NPI assigned

Sep 12, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Jill R. Cristo, MA LMFT LLC

Title

President

Phone

(860) 463-6723

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1252713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252713600000",
    "number": "1477886174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 NEW BRITAIN AVE",
            "address_2": "SUITE NUMBER 14",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061102427",
            "telephone_number": "860-463-6723",
            "fax_number": "860-233-4996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 COLONIAL DR N",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060022393",
            "telephone_number": "860-463-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JILL R. CRISTO MA LMFT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-12",
        "last_updated": "2009-09-12",
        "status": "A",
        "authorized_official_last_name": "CRISTO",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-463-6723",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA LMFT LLC"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "CT",
            "license": "000717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Bloomfield, CT
• Providers in Bloomfield, CT by specialty
• Exclusive Provider Organization in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.