Individual provider Active NPI

Susan A. Boritz, M.A.

  • Marriage & Family Therapist
  • Newtown, CT
National Provider Identifier
1639328974
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001240 Issued in CT
Practice address
25 Church Hill Rd Ste 201B
Newtown, CT 06470-1646
Phone
(203) 917-8585
Fax
(203) 826-2211
NPI assigned
Sep 11, 2008
Last updated
Apr 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000910 CT
Mental Health Counselor 101YM0800X 001240 CT
Marriage & Family Therapist 106H00000X 001240 CT Primary

Addresses

Primary practice location

25 Church Hill Rd Ste 201B
Newtown, CT 06470-1646

Mailing address

401A Heritage VLG
Southbury, CT 06488-5708
Phone (203) 917-8585

Other identifiers 1

IdentifierTypeStateIssuer
004257318MedicaidCT

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
I20240205001769 CT Practitioner - Marriage and Family Therapist 1658714837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

25 Church Hill Rd
Suite 201
Newtown, CT 06470-1646
Phone (203) 917-8585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
001240CTMDMental Health Counselor
000910CTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Counseling, LLC Marriage & Family Therapist CurrentSince Dec 18, 2023 Accepting new patients

Locations

25 Church Hill Rd
Ste 201
Newtown, CT 06470
Phone (203) 917-8585

25 Church Hill Rd
Ste 201B
Newtown, CT 06470
Phone (203) 917-8585

111 Church Hill Rd
Ste 305
Sandy Hook, CT 06482

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1639328974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401A HERITAGE VLG",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064885708",
            "telephone_number": "203-917-8585",
            "fax_number": "203-826-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHURCH HILL RD STE 201B",
            "city": "NEWTOWN",
            "state": "CT",
            "postal_code": "064701646",
            "telephone_number": "203-917-8585",
            "fax_number": "203-826-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORITZ",
        "first_name": "SUSAN",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "000910",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "001240",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004257318",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newtown, CT

Sources for this page

Verify at the official NPI Registry.