Active NPI
Jill Catherine Humphrey, LPC, NBCC, MS,BA
- Professional Counselor
- Waterbury, CT
National Provider Identifier
1487808143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 001348
- Practice address
- 141 E Main St
Wellmore Inc-3Rd Floor
Waterbury, CT 06702-2310 - Phone
- (203) 575-0456
- Fax
- (203) 575-1817
- NPI assigned
- Nov 7, 2008
- Last updated
- May 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 001348 | CT | Primary |
Addresses
Primary practice location
141 E Main St
Wellmore Inc-3Rd Floor
Waterbury, CT 06702-2310
Mailing address
141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060669107 | Other | CT | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| 539524 PENDING | Other | CT | MHN TRICARE NORTH |
| 539524 | Other | CT | MHN MANAGED HEALTHCARE |
| 008037434 | Medicaid | CT | |
| 060669107 | Other | CT | HEALTHYCT WELLMORE GRP/FACILITY |
| NBCC-62197 | Other | CT | NATIONAL BOARD OF CERTIFIED COUNSELORS |
| 060669107 | Other | CT | UBH- OXFORD FREEDOM/LIBERTY WELLMORE GRP/FACILITY |
| 060669107 | Other | CT | ANTHEM BCBS OF CT WELLMORE GRP/FACILITY |
| 060669107 | Other | CT | OPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY |
| 13540256 | Other | CT | CAQH |
| 4687873 | Other | CT | CIGNA BEHAVIORAL HEALTH |
| D339123 141 E MAIN | Other | CT | BEACON HEALTH STRATEGIES |
| 060669107 | Other | CT | UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY |
| 9403704 | Other | CT | AETNA BEHAVIORAL HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Bachelor of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001348 | CT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462924800000",
"number": "1487808143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"address_2": "4TH FLOOR ADMINISTRATION",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-574-9000",
"fax_number": "203-574-9006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"address_2": "WELLMORE INC-3RD FLOOR",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-575-0456",
"fax_number": "203-575-1817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUMPHREY",
"first_name": "JILL",
"middle_name": "CATHERINE",
"name_prefix": "Mrs.",
"credential": "LPC, NBCC, MS,BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-07",
"last_updated": "2016-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "001348",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH-CONNECTICARE WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN TRICARE NORTH",
"identifier": "539524 PENDING",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN MANAGED HEALTHCARE",
"identifier": "539524",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008037434",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHYCT WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL BOARD OF CERTIFIED COUNSELORS",
"identifier": "NBCC-62197",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH- OXFORD FREEDOM/LIBERTY WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS OF CT WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13540256",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "4687873",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON HEALTH STRATEGIES",
"identifier": "D339123 141 E MAIN",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL HEALTH",
"identifier": "9403704",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.