Active NPI
Kelly Fortin, LPC
- Professional Counselor
- Burlington, CT
National Provider Identifier
1740526672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2783
- Practice address
- 258 Spielman Hwy
Burlington, CT 06013-1723 - Phone
- (860) 351-7445
- NPI assigned
- Dec 21, 2012
- Last updated
- Mar 11, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | ||
| Professional Counselor | 101YP2500X | 2783 | CT | Primary |
Addresses
Primary practice location
258 Spielman Hwy
Burlington, CT 06013-1723
Mailing address
231 Catlin Rd
Harwinton, CT 06791-1714
Phone (860) 368-8665
Other practice location 1
56 Whiting St Unit 2
Plainville, CT 06062-7701
Phone (860) 351-7445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2783 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Center for Emotional Healing, LLC | Past | Accepting new patients | |
| Hop Brook Counseling Center, LLC | Professional | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Plainville, CT
- NPI 1104348192
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773187200000",
"number": "1740526672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 CATLIN RD",
"city": "HARWINTON",
"state": "CT",
"postal_code": "067911714",
"telephone_number": "860-368-8665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 SPIELMAN HWY",
"city": "BURLINGTON",
"state": "CT",
"postal_code": "060131723",
"telephone_number": "860-351-7445"
}
],
"practiceLocations": [
{
"address_1": "56 Whiting St Unit 2",
"address_purpose": "LOCATION",
"city": "Plainville",
"state": "CT",
"postal_code": "060627701",
"country_code": "US",
"telephone_number": "860-351-7445",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORTIN",
"first_name": "KELLY",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-21",
"last_updated": "2026-03-11",
"certification_date": "2026-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "2783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burlington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.