Individual provider Active NPI

Clare Criscuolo, LPC

  • Professional Counselor
  • Branford, CT
National Provider Identifier
1689306441
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5609 Issued in CT
Practice address
83 Montoya Dr
Branford, CT 06405-2529
Phone
(203) 464-3688
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5609 CT Primary

Addresses

Primary practice location

83 Montoya Dr
Branford, CT 06405-2529

Mailing address

11 Hughes St
East Haven, CT 06512-2614
Phone (203) 464-3688

Other names 1

  • Mrs. Clare Criscuolo Other name

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
I20250106000846 CT Practitioner - Mental Health Counselor 8921536905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
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
5609CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Nov 3, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Nov 3, 2024 Accepting new patients
Mindscapes Counseling PLLC Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: clare.criscuolo.1@28623.direct.athenahealth.com

Organizations & group practices 3

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": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1689306441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 HUGHES ST",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065122614",
            "telephone_number": "203-464-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 MONTOYA DR",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064052529",
            "telephone_number": "203-464-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISCUOLO",
        "first_name": "CLARE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "5609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARE",
            "last_name": "CRISCUOLO",
            "prefix": "MRS.",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Branford, CT

Sources for this page

Verify at the official NPI Registry.