Yasmin Perez-Maddelena, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

002430 Issued in CT

Practice address

1046 Fairfield Ave
1046 Fairfield Ave
Bridgeport, CT 06605-1116

Phone

(203) 330-6054

Fax

(203) 331-4716

NPI assigned

May 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Yasmin Perez Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cornell Scott Hill Health Corporation

  • Federally Qualified Health Center (FQHC)
  • New Haven, CT
  • NPI 1902921380
  Medicare reassignment NPD
• Sinfonia Counseling Services, LLC

  • Professional Counselor
  • West Haven, CT
  • NPI 1154043800
  NPD Authorized official

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510790400000",
    "number": "1689885667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-332-3556",
            "fax_number": "203-382-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 FAIRFIELD AVE",
            "address_2": "1046 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051116",
            "telephone_number": "203-330-6054",
            "fax_number": "203-331-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-MADDELENA",
        "first_name": "YASMIN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2017-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "002430",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YASMIN",
            "last_name": "PEREZ",
            "credential": "THERAPIST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren A Pepin, APRN
• Pequot Medical Associates, PC
• Brent Perdrizet, DPT
• David James Peregrim, P.A.-C
• Carolina Villanueva Pereira, LMSW
• Jennifer Marie Perez
• Joshua Perez
• Patricia Carla Perez
• Raul Perez Jr., MD
• Stephanie Perez, MS

• Professional Counselor in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.