Individual provider Active NPI

Luz Dellmisel Vicenty, LPC

  • Professional Counselor
  • Middletown, CT
National Provider Identifier
1619590759
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7942 Issued in CT
Practice address
675 Main St
Middletown, CT 06457-2732
Phone
(860) 347-6971
NPI assigned
May 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Professional Counselor 101YP2500X 7942 CT Primary

Addresses

Primary practice location

675 Main St
Middletown, CT 06457-2732

Mailing address

360 Bloomfield Ave Ste 301
Windsor, CT 06095-2700
Phone (877) 418-2978

Other practice location 1

360 Bloomfield Ave Ste 301
Windsor, CT 06095-2700
Phone (877) 418-2978

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241209002988 CT Practitioner - Mental Health Counselor 0941736334 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7942CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Sep 24, 2025 Accepting new patients
Community Health Center Inc CurrentSince Dec 4, 2024 Accepting new patients
Community Health Center Inc CurrentSince Dec 4, 2024 Accepting new patients

Locations

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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.

NPI Registry JSON

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

{
    "created_epoch": "1590192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1619590759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 BLOOMFIELD AVE STE 301",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952700",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 MAIN ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572732",
            "telephone_number": "860-347-6971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 Bloomfield Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Windsor",
            "state": "CT",
            "postal_code": "060952700",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VICENTY",
        "first_name": "LUZ",
        "middle_name": "DELLMISEL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-23",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "7942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.