Individual provider Active NPI

Melissa C. Perkins, LPC

  • Professional Counselor
  • Derby, CT
National Provider Identifier
1588070429
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2569 Issued in CT
Practice address
17 Elizabeth St
Derby, CT 06418-1840
Phone
(860) 324-0653
NPI assigned
Jul 10, 2014
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2569 CT Primary

Addresses

Primary practice location

17 Elizabeth St
Derby, CT 06418-1840

Mailing address

17 Elizabeth St
Derby, CT 06418-1840
Phone (203) 962-6589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240826002048 CT Practitioner - Mental Health Counselor 3274949326 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2569CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Inner Strength Counseling Professional CurrentSince Jul 26, 2024 Accepting new patients

Locations

17 Elizabeth St
Derby, CT 06418
Phone (203) 962-6589

10 Progress Dr
Shelton, CT 06484
Phone (203) 944-3718

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1588070429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ELIZABETH ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181840",
            "telephone_number": "203-962-6589",
            "fax_number": "475-777-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ELIZABETH ST",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181840",
            "telephone_number": "860-324-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "MELISSA",
        "middle_name": "C.",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, CT

Sources for this page

Verify at the official NPI Registry.