Individual provider Active NPI

Jessica Grzado, LMFT

  • Marriage & Family Therapist
  • Southington, CT
National Provider Identifier
1770048167
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2024 Issued in CT
Practice address
132 Main St FL 2
Southington, CT 06489-2561
Phone
(860) 245-1064
NPI assigned
Feb 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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 2024 CT Primary

Addresses

Primary practice location

132 Main St FL 2
Southington, CT 06489-2561

Mailing address

106 Cedar Hollow Dr
Rocky Hill, CT 06067-2641
Phone (860) 517-6263

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

State licenses

LicenseStateTypeSpecialty
2024CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Metamorphosis Counseling and Wellness, LLC CurrentSince Oct 10, 2021 Accepting new patients

Locations

132 Main St
Fl 2
Southington, CT 06489
Phone (860) 245-1064

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": "1549756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1770048167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 CEDAR HOLLOW DR",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672641",
            "telephone_number": "860-517-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MAIN ST FL 2",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892561",
            "telephone_number": "860-245-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRZADO",
        "first_name": "JESSICA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-10",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "2024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.