Individual provider Active NPI

Sandra L Fitzgerald, LPC,LADC

  • Counselor
  • Waterbury, CT
National Provider Identifier
1720060296
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
000511 Issued in CT
Practice address
64 Robbins St
Crisis Intervention Center
Waterbury, CT 06708-2613
Phone
(203) 573-6798
Fax
(203) 573-7007
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 000511 CT Primary
Counselor 101Y00000X 000641 CT

Addresses

Primary practice location

64 Robbins St
Crisis Intervention Center
Waterbury, CT 06708-2613

Mailing address

326 Todd Rd
Wolcott, CT 06716-2831
Phone (203) 879-6287

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
I20240125004594 CT Practitioner - Mental Health Counselor 0042663064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Healthy Mind Psychiatric Services PCGroup PAC ID 4082874672, 5 clinicians

Practice addresses (Care Compare)

900 Straits Tpke
Suite D
Middlebury, CT 06762-2800
Phone (203) 270-5575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000511CTMDCounselor
000641CTMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Healthy Mind Psychiatric Services PC Counselor CurrentSince Jan 1, 2024 Accepting new patients

Locations

900 Straits Tpke
Ste D
Middlebury, CT 06762
Phone (203) 270-5575

60 Westwood Ave
Ste 230
Waterbury, CT 06708
Phone (203) 753-2800

133 Scovill St
Ste 102
Waterbury, CT 06706
Phone (203) 270-5575

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720060296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 TODD RD",
            "city": "WOLCOTT",
            "state": "CT",
            "postal_code": "067162831",
            "telephone_number": "203-879-6287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 ROBBINS ST",
            "address_2": "CRISIS INTERVENTION CENTER",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082613",
            "telephone_number": "203-573-6798",
            "fax_number": "203-573-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "SANDRA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LPC,LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "000511",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "000641",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.