Judith Dissell Balcezak, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

2885 Issued in CT

Practice address

132 Grove St.
Torrington, CT 06790

Phone

(860) 482-5558

NPI assigned

Mar 4, 2009

Last updated

Jul 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Mental Health Counselor

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catholic Charities Inc Archdiocese of HartfordGroup PAC ID 2567367469, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/ccaoh/r4/

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.

• Catholic Charities, Inc. - Archdiocese of Hartford

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Torrington, CT
  • NPI 1669566956
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  CT

  Medicare reassignment NPD
• Catholic Charities, Inc. - Archdiocese of Hartford

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Milford, CT
  • NPI 1124112347
  NPD

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

{
    "created_epoch": "1236124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1770723702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 GROVE ST.",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "860-482-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 GROVE ST.",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "860-482-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALCEZAK",
        "first_name": "JUDITH",
        "middle_name": "DISSELL",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-04",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CT",
            "license": "2885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Torrington, CT
• Providers in Torrington, CT by specialty
• Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.