Individual provider Active NPI

Susana Yazmin Shymanik, LPC

  • Professional Counselor
  • Dayville, CT
National Provider Identifier
1790194959
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
007823 Issued in CT
Practice address
1007 N Main St
Dayville, CT 06241-2170
Phone
(860) 774-2020
Fax
(860) 774-0826
NPI assigned
Aug 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 007823 CT Primary

Addresses

Primary practice location

1007 N Main St
Dayville, CT 06241-2170

Mailing address

1007 N Main St
Dayville, CT 06241-2170
Phone (860) 774-2020

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
I20250522000548 CT Practitioner - Mental Health Counselor 8921527086 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Services Inc CurrentSince May 15, 2025 Accepting new patients
Bridge Youth & Family Services PastSince Feb 6, 2022 Accepting new patients
Bridge Youth & Family Services Past Accepting new patients

Locations

140 N Frontage Rd
Mansfield Ctr, CT 06250
Phone (860) 456-2261

Organizations & group practices 3

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": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1790194959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 N MAIN ST",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "062412170",
            "telephone_number": "860-774-2020",
            "fax_number": "860-774-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 N MAIN ST",
            "city": "DAYVILLE",
            "state": "CT",
            "postal_code": "062412170",
            "telephone_number": "860-774-2020",
            "fax_number": "860-774-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHYMANIK",
        "first_name": "SUSANA",
        "middle_name": "YAZMIN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "007823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayville, CT

Sources for this page

Verify at the official NPI Registry.