Kristin Ferguson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

005318 Issued in CT

Practice address

2 Briar CLF
Burlington, CT 06013-2233

Phone

(860) 368-8665

NPI assigned

Jun 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 26, 2024 through Jun 26, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Center for Emotional Healing, LLC

  • Community/Behavioral Health Agency
  • Plainville, CT
  • NPI 1104348192
  NPD (past)

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

{
    "created_epoch": "1654732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1679202030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WHITING ST UNIT 846",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060627734",
            "telephone_number": "860-368-8665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BRIAR CLF",
            "city": "BURLINGTON",
            "state": "CT",
            "postal_code": "060132233",
            "telephone_number": "860-368-8665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERGUSON",
        "first_name": "KRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-09",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "005318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Connecticut CVS Pharmacy LLC
• David Schwaber D.D.S.
• Elite Smiles Artistry, PLLC
• Elite Smiles Dental Group LLC
• Encompass Behavior Services LLC
• Caroline Bensam Finley, L.C.S.W.
• Drew Fisher
• Shirley Fontaine
• Kelly Fortin, LPC
• Christal Furphy, LCSW

• All providers in Burlington, CT
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.