Active NPI
Sandra Elizabeth Carlo, LMFT
- Marriage & Family Therapist
- Stratford, CT
National Provider Identifier
1619030665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 001010
- Practice address
- 3380 Main St
Suite 201
Stratford, CT 06614-4860 - Phone
- (203) 767-9629
- NPI assigned
- Dec 19, 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 001010 | CT | Primary |
Addresses
Primary practice location
3380 Main St
Suite 201
Stratford, CT 06614-4860
Mailing address
3380 Main St
Suite 201
Stratford, CT 06614-4860
Phone (203) 767-9629
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7251549 | Other | CT | AETNA PROVIDER ID |
| 62-73452 | Other | CT | UNITED HEALTHCARE ID |
| 304198 | Other | CT | MHN PROVIDER ID |
| 410001010CT06 | Other | CT | ANTHEM BCBS PROVIDER ID |
| P3179321 | Other | CT | OXFORD HEALTH PROVIDER ID |
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 |
|---|---|---|---|
| 001010 | CT | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619030665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3380 MAIN ST",
"address_2": "SUITE 201",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066144860",
"telephone_number": "203-767-9629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3380 MAIN ST",
"address_2": "SUITE 201",
"city": "STRATFORD",
"state": "CT",
"postal_code": "066144860",
"telephone_number": "203-767-9629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLO",
"first_name": "SANDRA",
"middle_name": "ELIZABETH",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CT",
"license": "001010",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER ID",
"identifier": "7251549",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE ID",
"identifier": "62-73452",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN PROVIDER ID",
"identifier": "304198",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS PROVIDER ID",
"identifier": "410001010CT06",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PROVIDER ID",
"identifier": "P3179321",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stratford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.