Individual provider Active NPI

Kathleen Rosenfeld, LMFT

  • Marriage & Family Therapist
  • Bridgeport, CT
National Provider Identifier
1700208048
Registry record updated Jan 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001636 Issued in CT
Practice address
475 Clinton Ave
Bridgeport, CT 06605-1700
Phone
(203) 368-4291
Fax
(203) 368-9167
NPI assigned
Jan 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001636 CT Primary

Addresses

Primary practice location

475 Clinton Ave
Bridgeport, CT 06605-1700

Mailing address

475 Clinton Ave
Bridgeport, CT 06605-1700
Phone (203) 368-4291

Other identifiers 1

IdentifierTypeStateIssuer
004069985MedicaidCT

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
I20240730002033 CT Practitioner - Marriage and Family Therapist 3678010436

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001636CTMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388966400000",
    "number": "1700208048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 CLINTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051700",
            "telephone_number": "203-368-4291",
            "fax_number": "203-368-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 CLINTON AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051700",
            "telephone_number": "203-368-4291",
            "fax_number": "203-368-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENFELD",
        "first_name": "KATHLEEN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2014-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004069985",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.