Individual provider Active NPI

Crystal M Colon, LMFT

  • Marriage & Family Therapist
  • Ellington, CT
National Provider Identifier
1720609118
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
99 Stafford Rd Ste B-1
Ellington, CT 06029-2834
Phone
(860) 874-7756
NPI assigned
Apr 27, 2020
Last updated
Sep 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2671 CT
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

99 Stafford Rd Ste B-1
Ellington, CT 06029-2834

Mailing address

61 Egypt Rd
Ellington, CT 06029-2405
Phone (860) 874-7756

Other practice location 1

7B Ledgebrook Dr
Mansfield Center, CT 06250-1664
Phone (860) 731-5522

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

LicenseStateTypeSpecialty
2671CTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1720609118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 EGYPT RD",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060292405",
            "telephone_number": "860-874-7756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 STAFFORD RD STE B-1",
            "city": "ELLINGTON",
            "state": "CT",
            "postal_code": "060292834",
            "telephone_number": "860-874-7756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7B Ledgebrook Dr",
            "address_purpose": "LOCATION",
            "city": "Mansfield Center",
            "state": "CT",
            "postal_code": "062501664",
            "country_code": "US",
            "telephone_number": "860-731-5522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLON",
        "first_name": "CRYSTAL",
        "middle_name": "M",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-27",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "2671",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.