Individual provider Active NPI

Amanda J Sperandio, LMFT

  • Marriage & Family Therapist
  • New Haven, CT
National Provider Identifier
1629428297
Registry record updated Sep 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001762 Issued in CT
Practice address
232 Cedar St
New Haven, CT 06519-1610
Phone
(203) 503-3300
Fax
(203) 401-3352
NPI assigned
Jun 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001762 CT Primary

Addresses

Primary practice location

232 Cedar St
New Haven, CT 06519-1610

Mailing address

400 Columbus Ave
New Haven, CT 06519-1233
Phone (203) 503-3174

Other identifiers 1

IdentifierTypeStateIssuer
004235918MedicaidCT

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
I20240610003720 CT Practitioner - Marriage and Family Therapist 2264974880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

341 W St
Unit B
Plantsville, CT 06479-1140
Phone (203) 819-0789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001762CTMDOccupational Therapy Assistant
1762CTMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Sperandio, LMFT Current Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince May 5, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince May 5, 2024 Accepting new patients
Mindscapes Counseling PLLC Past Accepting new patients

Locations

169 Main St
Fl 3
Middletown, CT 06457
Phone (610) 618-6247

Organizations & group practices 4

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": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1629428297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3174",
            "fax_number": "203-503-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 CEDAR ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191610",
            "telephone_number": "203-503-3300",
            "fax_number": "203-401-3352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERANDIO",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235918",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.