Brenna Catherine Crockwell, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

776 Issued in CT

Practice address

2 Pomperaug Office Park Ste 307
Southbury, CT 06488-2293

Phone

(203) 264-8201

NPI assigned

Jul 4, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southbury Audiology LLCGroup PAC ID 9931419348, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southbury Audiology LLC

  • Audiologist
  • Southbury, CT
  • NPI 1932575610
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720051200000",
    "number": "1598501918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK STE 307",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882293",
            "telephone_number": "203-264-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 POMPERAUG OFFICE PARK STE 307",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064882293",
            "telephone_number": "203-264-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCKWELL",
        "first_name": "BRENNA",
        "middle_name": "CATHERINE",
        "credential": "AUD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-04",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer J. Coscia, LMFT
• Donna Lynn Costa, LPC
• Timothy Cotsalas
• Justina Courgi
• Creative Outlooks LLC
• Kristian Karl Cruz
• Crystal Clear Counseling
• CT Watermark East Hill, LLC
• Jason David Culp, N.D.
• Yanike Curry, LADC

• Audiologist in Southbury, CT
• Providers in Southbury, CT by specialty
• Audiologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.