Active NPI
Melissa A Fairhurst, NCC, LPC
- Professional Counselor
- Monroe, CT
National Provider Identifier
1700297579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 003148
- Practice address
- 731 Main St Ste 122
Monroe, CT 06468-2872 - Phone
- (203) 261-7090
- NPI assigned
- May 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 003148 | CT | Primary |
Addresses
Primary practice location
731 Main St Ste 122
Monroe, CT 06468-2872
Mailing address
13 Roosevelt Dr
Newtown, CT 06470-2035
Phone (203) 257-7930
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
| License | State | Type | Specialty |
|---|---|---|---|
| 003148 | CT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Key Therapy LLC | Current | Accepting new patients |
Locations
731 Main St
Ste 122
Monroe, CT 06468
Phone (203) 261-7090
Organizations & group practices 1
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.
-
- Marriage & Family Therapist
- Monroe, CT
- NPI 1114393493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1700297579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 ROOSEVELT DR",
"city": "NEWTOWN",
"state": "CT",
"postal_code": "064702035",
"telephone_number": "203-257-7930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 MAIN ST STE 122",
"city": "MONROE",
"state": "CT",
"postal_code": "064682872",
"telephone_number": "203-261-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRHURST",
"first_name": "MELISSA",
"middle_name": "A",
"credential": "NCC, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "003148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.