Mikala Marie Coppolella, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5741 Issued in CT

Practice address

55 Walls Dr Ste 206
Fairfield, CT 06824-5180

Phone

(203) 689-8989

NPI assigned

Sep 23, 2021

Last updated

Jul 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emh Family Services PCGroup PAC ID 9931561982, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emh Family Services PC

  dba Ellie Mental Health

  • Marriage & Family Therapist
  • Fairfield, CT
  • NPI 1619611464
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1720759350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 EDWARD ST",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065164104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WALLS DR STE 206",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245180",
            "telephone_number": "203-689-8989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Myrtle Ave",
            "address_purpose": "LOCATION",
            "city": "Westport",
            "state": "CT",
            "postal_code": "068803511",
            "country_code": "US",
            "telephone_number": "203-526-3215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPPOLELLA",
        "first_name": "MIKALA",
        "middle_name": "MARIE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "5187",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "5741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Contemporary TMS of Fairfield LLC
• Jane Ann Conway, LCSW
• Edwin R Cook, DDS
• Emma S Cooke, ND
• Megan Cooke, PHARMD
• Tara Core, LPCA
• Nicole E Cornelio, PA
• Cosmetic and Reconstructive Dentistry
• Cosmetic and Reconstructive Dentistry Associates, P.C.
• Catherine Cote

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.