Organization Active NPI

Linda S Mittenthal LCSW, LLC

  • Mental Health Counselor
  • Glastonbury, CT
National Provider Identifier
1487284683
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LINDA S MITTENTHAL LCSW, LLC
Practice address
99 Citizens Dr
Glastonbury, CT 06033-1262
Phone
(860) 517-6633
NPI assigned
Jan 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Authorized official

Name
Maggie Pires
Title
Office Manager
Phone
(860) 517-6633

Specialties & licenses 1

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

Addresses

Primary practice location

99 Citizens Dr
Glastonbury, CT 06033-1262

Mailing address

99 Citizens Dr
Glastonbury, CT 06033-1262
Phone (860) 517-6633

Other identifiers 1

IdentifierTypeStateIssuer
D400415577MedicaidCT

National Provider Directory

National Provider Directory

Locations

99 Citizens Dr
Glastonbury, CT 06033
Phone (860) 281-8412

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1487284683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 CITIZENS DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331262",
            "telephone_number": "860-517-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 CITIZENS DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060331262",
            "telephone_number": "860-517-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA S MITTENTHAL LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "PIRES",
        "authorized_official_first_name": "MAGGIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-517-6633"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D400415577",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.