Active NPI
Doreen Rousseau Smith, LPC LIC PROF COUNS
- Counselor
- West Hartford, CT
National Provider Identifier
1497853261
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 000109
- Practice address
- 90 N Main St
West Hartford, CT 06107-1924 - Phone
- (860) 983-7507
- Fax
- (860) 561-0489
- NPI assigned
- Sep 20, 2006
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 000109 | CT | Primary |
Addresses
Primary practice location
90 N Main St
West Hartford, CT 06107-1924
Mailing address
10 Northfield
West Hartford, CT 06107-3321
Phone (860) 561-0489
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000109 | Other | CT | PROFESSIONAL LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000109 | CT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186963200000",
"number": "1497853261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 NORTHFIELD",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061073321",
"telephone_number": "860-561-0489",
"fax_number": "860-561-0489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 N MAIN ST",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061071924",
"telephone_number": "860-983-7507",
"fax_number": "860-561-0489"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "DOREEN",
"middle_name": "ROUSSEAU",
"credential": "LPC LIC PROF COUNS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CT",
"license": "000109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL LICENSE",
"identifier": "000109",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.