Susan P Sidway, MS, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

001484 Issued in CT

Practice address

100 Bank Street
Suite 306
Seymour, CT 06483

Phone

(203) 888-0462

Fax

(203) 888-1465

NPI assigned

Oct 12, 2011

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Sidway Counseling, LLC

  • Marriage & Family Therapist
  • Watertown, CT
  • NPI 1881965002
  NPD (past) Authorized official
• CCM Psychotherapy, LLC

  • Clinical Social Worker
  • Watertown, CT
  • NPI 1306129119
  NPD (past)
• Rimmon Pond Counseling LLC

  • Mental Health Counselor
  • Seymour, CT
  • NPI 1932325669
  NPD (past)

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1619252400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 WESTBURY PARK ROAD",
            "address_2": "SUITE 303E",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06795",
            "telephone_number": "203-525-2091",
            "fax_number": "860-417-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BANK STREET",
            "address_2": "SUITE 306",
            "city": "SEYMOUR",
            "state": "CT",
            "postal_code": "06483",
            "telephone_number": "203-888-0462",
            "fax_number": "203-888-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDWAY",
        "first_name": "SUSAN",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-12",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seymour Optometric Center, LLC
• Shady Knoll Acquisition Operator LLC
• Shady Knoll Health Care Center, Inc.
• Shady Knoll Health Center, Inc
• Nagesh D Shrestha, D.D.S.
• Tanya Ronnette Simpson
• Solara ABA CT LLC
• Sycamore Counseling Services LLC
• Terra Psychological Services LLC
• Ashley Rae Tessier, LPC

• Marriage & Family Therapist in Seymour, CT
• Providers in Seymour, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.