Individual provider Active NPI

Danielle Drugan, LMFT

  • Marriage & Family Therapist
  • Groton, CT
National Provider Identifier
1568775450
Registry record updated Apr 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1404 Issued in CT
Practice address
112 New London Rd # Suirea
Groton, CT 06340-4869
Phone
(860) 961-5702
NPI assigned
Jul 20, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1404 CT Primary

Addresses

Primary practice location

112 New London Rd # Suirea
Groton, CT 06340-4869

Mailing address

21 New London Rd
Mystic, CT 06355-2468
Phone (860) 961-5702

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

LicenseStateTypeSpecialty
1404CTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mystic Therapy, LLC. Marriage & Family Therapist CurrentSince Apr 10, 2022 Accepting new patients

Locations

49 Whitehall Ave
Mystic, CT 06355
Phone (203) 927-7364

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1568775450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 NEW LONDON RD",
            "city": "MYSTIC",
            "state": "CT",
            "postal_code": "063552468",
            "telephone_number": "860-961-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 NEW LONDON RD # SUIREA",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404869",
            "telephone_number": "860-961-5702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRUGAN",
        "first_name": "DANIELLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.