Melissa Leigh Costanzo, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

00930 Issued in CT

Practice address

675 Tower Ave
Suite 301
Hartford, CT 06112-1273

Phone

(860) 714-2750

Fax

(860) 714-8591

NPI assigned

Nov 28, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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

Marriage and Family Therapist

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Group practices

Peaceful Mind Behavioral Health and Wellness LLCGroup PAC ID 0941683056, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Peaceful Mind Behavioral Health & Wellness, LLC

  • Mental Health Counselor
  • Bristol, CT
  • NPI 1255926358

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD
• Peaceful Mind Behavioral Health & Wellness, LLC

  • Mental Health Counselor
  • Bristol, CT
  • NPI 1275321846

  Marriage & Family Therapist

  NPD

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

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1750626032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "SUITE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121273",
            "telephone_number": "860-714-2750",
            "fax_number": "860-714-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "SUITE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121273",
            "telephone_number": "860-714-2750",
            "fax_number": "860-714-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANZO",
        "first_name": "MELISSA",
        "middle_name": "LEIGH",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-28",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "00930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan George-John Cosmopoulos
• Emma Lynn Costa
• Maxine Costa, APRN
• Monika Costa, ED.D, MSN, RN, IBCLC
• Katherine Costanzo, PA
• Nicholas John Costanzo, M.D.
• Amy Costello, CRNA
• Lauren Costigan, MD
• Melissa L Cote, CADC
• Barbara Fisher Coughlin, M.D.

• Marriage & Family Therapist in Hartford, CT
• Providers in Hartford, CT by specialty
• Marriage & Family Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.