NPIMap

Organization Active NPI

Introspective Counseling LLC

  • Marriage & Family Therapist
  • Bristol, CT
National Provider Identifier
1720491087
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001140 Issued in CT
Legal business name
INTROSPECTIVE COUNSELING LLC
Practice address
22 Pine St
Suite 205
Bristol, CT 06010-6948
Phone
(860) 845-2068
Fax
(860) 845-2365
NPI assigned
Jun 4, 2014
Last updated
Jun 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Authorized official

Name
Karen Reardon, LMFT
Title
Manager
Phone
(860) 845-2068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001140 CT Primary

Addresses

Primary practice location

22 Pine St
Suite 205
Bristol, CT 06010-6948

Mailing address

22 Pine St
Suite 205
Bristol, CT 06010-6948
Phone (860) 845-2068

Other identifiers 1

IdentifierTypeStateIssuer
004257334MedicaidCT

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1401840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401840000000",
    "number": "1720491087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "address_2": "SUITE 205",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106948",
            "telephone_number": "860-845-2068",
            "fax_number": "860-845-2365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PINE ST",
            "address_2": "SUITE 205",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060106948",
            "telephone_number": "860-845-2068",
            "fax_number": "860-845-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTROSPECTIVE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-04",
        "last_updated": "2014-06-04",
        "status": "A",
        "authorized_official_last_name": "REARDON",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-845-2068",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004257334",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.