Individual provider Active NPI

Jill J Parkosewich, LMFT

  • Marriage & Family Therapist
  • Shelton, CT
National Provider Identifier
1730227091
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
25 Church St
Shelton, CT 06484-5802
Phone
(203) 929-1117
NPI assigned
Feb 1, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

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

Addresses

Primary practice location

25 Church St
Shelton, CT 06484-5802

Mailing address

25 Church St
Shelton, CT 06484-5802
Phone (203) 929-1117

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
I20240216002687 CT Practitioner - Marriage and Family Therapist 0345684478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Christian Counseling and Family Life Center, Inc.Group PAC ID 4688637010, 9 clinicians

Practice addresses (Care Compare)

183 Howe Ave
Shelton, CT 06484-3323
Phone (203) 929-1117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000941CTMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Christian Counseling and Family Life Center, Inc. Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

183 Howe Ave
Shelton, CT 06484
Phone (203) 200-0309

25 Church St
Shelton, CT 06484
Phone (203) 929-1117

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730227091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CHURCH ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064845802",
            "telephone_number": "203-929-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHURCH ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064845802",
            "telephone_number": "203-929-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKOSEWICH",
        "first_name": "JILL",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

Verify at the official NPI Registry.