Individual provider Active NPI

Lissette Larue, LPC

  • Professional Counselor
  • Gales Ferry, CT
National Provider Identifier
1629314620
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2321 Issued in CT
Practice address
1649 Route 12
Suite 4
Gales Ferry, CT 06335-1545
Phone
(860) 578-2349
NPI assigned
Dec 19, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2321 CT Primary

Addresses

NPPES NPI Registry

Primary practice location

1649 Route 12
Suite 4
Gales Ferry, CT 06335-1545

Mailing address

1649 Route 12
Suite 4
Gales Ferry, CT 06335-1545
Phone (860) 578-2349

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 18, 2016.

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1629314620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1649 ROUTE 12",
            "address_2": "SUITE 4",
            "city": "GALES FERRY",
            "state": "CT",
            "postal_code": "063351545",
            "telephone_number": "860-578-2349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 ROUTE 12",
            "address_2": "SUITE 4",
            "city": "GALES FERRY",
            "state": "CT",
            "postal_code": "063351545",
            "telephone_number": "860-578-2349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUE",
        "first_name": "LISSETTE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gales Ferry, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.