Individual provider Active NPI

Michael Daniel Petras II, LMFT

  • Marriage & Family Therapist
  • Milford, CT
National Provider Identifier
1730631888
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1 Golden Hill St
Milford, CT 06460-4630
Phone
(203) 882-2066
NPI assigned
Oct 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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 Primary

Addresses

Primary practice location

1 Golden Hill St
Milford, CT 06460-4630

Mailing address

1204 Main St # 228
Branford, CT 06405-3787
Phone (203) 843-4456

Other practice location 1

605 Washington Ave
North Haven, CT 06473-1123
Phone (203) 701-9884

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mr. Therapy Guy LLC Marriage & Family Therapist Current Accepting new patients

Locations

1204 Main St
Branford, CT 06405
Phone (203) 518-8447

605 Washington Ave
North Haven, CT 06473
Phone (203) 767-5638

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": "1477353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1730631888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MAIN ST # 228",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053787",
            "telephone_number": "203-843-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GOLDEN HILL ST",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604630",
            "telephone_number": "203-882-2066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "605 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "North Haven",
            "state": "CT",
            "postal_code": "064731123",
            "country_code": "US",
            "telephone_number": "203-701-9884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRAS",
        "first_name": "MICHAEL",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-25",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.