Individual provider Active NPI

Naza Bungu, LPC, LADC

  • Professional Counselor
  • West Haven, CT
National Provider Identifier
1770881815
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2029 Issued in CT
Practice address
840 Boston Post Rd Ste 5
West Haven, CT 06516-1848
Phone
(203) 848-9350
NPI assigned
Mar 13, 2011
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1186 CT
Professional Counselor 101YP2500X 2029 CT Primary

Addresses

Primary practice location

840 Boston Post Rd Ste 5
West Haven, CT 06516-1848

Mailing address

840 Boston Post Rd Ste 5
West Haven, CT 06516-1848
Phone (203) 848-9350

Other identifiers 1

IdentifierTypeStateIssuer
008045424MedicaidCT

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
1186CTMDAddiction (Substance Use Disorder) Counselor
2029CTMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Naza Bungu LLC Addiction (Substance Use Disorder) CurrentSince Jun 1, 2020 Accepting new patients

Locations

57 Plains Rd
Ste 1B
Milford, CT 06461
Phone (203) 400-8607

840 Boston Post Rd
West Haven, CT 06516
Phone (203) 445-6593

840 Boston Post Rd
Ste 5
West Haven, CT 06516
Phone (203) 848-9350

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1299974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1770881815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 BOSTON POST RD STE 5",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161848",
            "telephone_number": "203-848-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 BOSTON POST RD STE 5",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161848",
            "telephone_number": "203-848-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNGU",
        "first_name": "NAZA",
        "credential": "LPC, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-13",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "1186",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "2029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008045424",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.