Active NPI
Yezenia Luna, BS, CAC
- Addiction (Substance Use Disorder) Counselor
- Bridgeport, CT
National Provider Identifier
1497074710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CAC 4497
- Practice address
- 1046 Fairfield Ave
Bridgeport, CT 06605-1116 - Phone
- (203) 330-6504
- Fax
- (203) 331-4716
- NPI assigned
- May 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAC 4497 | CT | Primary |
Addresses
Primary practice location
1046 Fairfield Ave
Bridgeport, CT 06605-1116
Mailing address
301 Funston Ave
Bridgeport, CT 06606-3038
Phone (203) 339-1736
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)
- Not enrolled
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAC 4497 | CT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274832000000",
"number": "1497074710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "301 FUNSTON AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066063038",
"telephone_number": "203-339-1736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1046 FAIRFIELD AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066051116",
"telephone_number": "203-330-6504",
"fax_number": "203-331-4716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNA",
"first_name": "YEZENIA",
"credential": "BS, CAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-26",
"last_updated": "2010-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CT",
"license": "CAC 4497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.