Individual provider Active NPI

Bryan Kelly, LMFT

  • Marriage & Family Therapist
  • Naugatuck, CT
National Provider Identifier
1780484048
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
002629 Issued in CT
Practice address
260 Spring St Apt 3
Naugatuck, CT 06770-2940
Phone
(631) 566-2934
NPI assigned
Mar 17, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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 002629 CT Primary

Addresses

Primary practice location

260 Spring St Apt 3
Naugatuck, CT 06770-2940

Mailing address

260 Spring St Apt 3
Naugatuck, CT 06770-2940
Phone (757) 427-4047

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250930000484 CT Practitioner - Marriage and Family Therapist 8729584727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

95 Barbara Rd
Bristol, CT 06010-3808

984 Southford Rd
Middlebury, CT 06762-3234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002629CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Center for Counseling & Learning, LLC Marriage & Family Therapist CurrentSince Sep 1, 2025 Accepting new patients
Compassionate Care Counseling LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

984 Southford Rd
Middlebury, CT 06762
Phone (203) 758-2400

1000 Bridgeport Ave
Ste 202
Shelton, CT 06484
Phone (203) 712-9998

Organizations & group practices 2

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": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1780484048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 SPRING ST APT 3",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067702940",
            "telephone_number": "757-427-4047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SPRING ST APT 3",
            "city": "NAUGATUCK",
            "state": "CT",
            "postal_code": "067702940",
            "telephone_number": "631-566-2934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRYAN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "002629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naugatuck, CT

Sources for this page

Verify at the official NPI Registry.