Active NPI
Juanita Crispin
- Mental Health Counselor
- Bloomfield, CT
National Provider Identifier
1619159381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 693 Bloomfield Ave
Bloomfield, CT 06002-2489 - Phone
- (860) 243-6584
- Fax
- (860) 243-6591
- NPI assigned
- Dec 4, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
693 Bloomfield Ave
Bloomfield, CT 06002-2489
Mailing address
58 Taylor Dr
Hartford, CT 06120-1019
Phone (860) 416-0678
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1619159381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "58 TAYLOR DR",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061201019",
"telephone_number": "860-416-0678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "693 BLOOMFIELD AVE",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060022489",
"telephone_number": "860-243-6584",
"fax_number": "860-243-6591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRISPIN",
"first_name": "JUANITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-04",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.