Individual provider Active NPI

Janna Marie Phillips, L.C.S.W.

  • Mental Health Counselor
  • West Hartford, CT
National Provider Identifier
1669774352
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1524 Issued in CO
Practice address
784 Farmington Ave
West Hartford, CT 06119-1619
Phone
(860) 523-4450
NPI assigned
Dec 1, 2010
Last updated
Oct 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1524 CO Primary

Addresses

Primary practice location

784 Farmington Ave
West Hartford, CT 06119-1619

Mailing address

75 Foxcroft Rd
West Hartford, CT 06119-1060
Phone (303) 507-6345

Other practice location 1

75 Foxcroft Rd
West Hartford, CT 06119-1060
Phone (303) 507-6345

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1524COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clementine Counseling CurrentSince May 7, 2023 Accepting new patients
Women's Center for Psychotherapy,LLC CurrentSince Dec 22, 2019 Accepting new patients

Locations

784 Farmington Ave
West Hartford, CT 06119
Phone (860) 245-9077

Organizations & group practices 2

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": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1669774352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FOXCROFT RD",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191060",
            "telephone_number": "303-507-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "784 FARMINGTON AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061191619",
            "telephone_number": "860-523-4450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Foxcroft Rd",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061191060",
            "country_code": "US",
            "telephone_number": "303-507-6345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JANNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "1524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.