Juan Faraoni III, PSYA.D., LPC, LMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3078 Issued in CT

Practice address

660 Prospect Ave Ste 301
Hartford, CT 06105-4230

Phone

(860) 400-2428

NPI assigned

Feb 7, 2017

Last updated

Sep 3, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1710425087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 EDGEMERE AVE",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061101003",
            "telephone_number": "617-908-1228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 PROSPECT AVE STE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061054230",
            "telephone_number": "860-400-2428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1581 Beacon St",
            "address_purpose": "LOCATION",
            "city": "Brookline",
            "state": "MA",
            "postal_code": "024464602",
            "country_code": "US",
            "telephone_number": "617-908-1228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARAONI",
        "first_name": "JUAN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PSYA.D., LPC, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20181",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "11153",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.