Active NPI
Sherie Etienne
- Counselor
- Enfield, CT
National Provider Identifier
1619536182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 153 Hazard Ave
Enfield, CT 06082-4592 - Phone
- (860) 253-5020
- Fax
- (860) 253-5030
- NPI assigned
- Jun 10, 2019
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
153 Hazard Ave
Enfield, CT 06082-4592
Mailing address
2 Waterside Xing Ste 401
Windsor, CT 06095-1587
Phone (860) 697-3351
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
55 W Main St
Suite 410
Waterbury, CT 06702-5501
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Connecticut | Current | Accepting new patients | |
| Discovering Me Therapeutic Services LLC | Current | Accepting new patients | |
| State of Connecticut | Current | Accepting new patients |
Locations
95 Thomaston Ave
Waterbury, CT 06702
Phone (203) 805-5300
Organizations & group practices 3
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.
-
- Adult Mental Health Clinic/Center
- Waterbury, CT
- NPI 1841225489
-
- Community/Behavioral Health Agency
- Bristol, CT
- NPI 1023749850
-
- Skilled Nursing Facility
- Rocky Hill, CT
- NPI 1205951662
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560124800000",
"number": "1619536182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 WATERSIDE XING STE 401",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060951587",
"telephone_number": "860-697-3351",
"fax_number": "860-731-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 HAZARD AVE",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060824592",
"telephone_number": "860-253-5020",
"fax_number": "860-253-5030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE",
"first_name": "SHERIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-10",
"last_updated": "2019-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.