Active NPI
Kimberly Conley
- Professional Counselor
- North Haven, CT
National Provider Identifier
1750769873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2743
- Practice address
- 33 Bernhard Rd
North Haven, CT 06473-3900 - Phone
- (610) 454-8308
- NPI assigned
- May 8, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2743 | CT | Primary |
Addresses
Primary practice location
33 Bernhard Rd
North Haven, CT 06473-3900
Mailing address
514 Hunting Hill Ave
Middletown, CT 06457-5208
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260604002116 | CT | Practitioner - Mental Health Counselor | 0244701845 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1290 Silas Deane Hwy
Wethersfield, CT 06109
514 Hunting Hill Ave
Middletown, CT 06457-5208
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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": "1431043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431043200000",
"number": "1750769873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 HUNTING HILL AVE",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064575208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 BERNHARD RD",
"city": "NORTH HAVEN",
"state": "CT",
"postal_code": "064733900",
"telephone_number": "610-454-8308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLEY",
"first_name": "KIMBERLY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-08",
"last_updated": "2015-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "2743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.