Active NPI
Robert Juarez
- Mental Health Counselor
- New Britain, CT
National Provider Identifier
1770620452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 92 Vine St
New Britain, CT 06052-1433 - Phone
- (860) 223-9291
- Fax
- (860) 223-3111
- NPI assigned
- Jan 31, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary |
Addresses
Primary practice location
92 Vine St
New Britain, CT 06052-1433
Mailing address
92 Vine St
New Britain, CT 06052-1433
Phone (860) 223-9291
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CTGA000438 B000602 | Other | CT | SAGA |
| CTGA000438 B810006 | Other | CT | SAGA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1770620452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "92 VINE ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060521433",
"telephone_number": "860-223-9291",
"fax_number": "860-223-3111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92 VINE ST",
"city": "NEW BRITAIN",
"state": "CT",
"postal_code": "060521433",
"telephone_number": "860-223-9291",
"fax_number": "860-223-3111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUAREZ",
"first_name": "ROBERT",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-31",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAGA",
"identifier": "CTGA000438 B000602",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SAGA",
"identifier": "CTGA000438 B810006",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Britain, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.