Individual provider Active NPI

Ann Marie Pacheco, LMFT

  • Marriage & Family Therapist
  • Mansfield Center, CT
National Provider Identifier
1790907640
Registry record updated Mar 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
000531 Issued in CT
Practice address
2 Mansfield Hollow Rd
Mansfield Center, CT 06250-1314
Phone
(860) 423-0877
Fax
(860) 423-0877
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2024

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 000531 CT Primary

Addresses

Primary practice location

2 Mansfield Hollow Rd
Mansfield Center, CT 06250-1314

Mailing address

2 Mansfield Hollow Rd
Mansfield Center, CT 06250-1314
Phone (860) 423-0877

Other identifiers 1

IdentifierTypeStateIssuer
004202008MedicaidCT

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
I20240627002761 CT Practitioner - Marriage and Family Therapist 4284075482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 Mansfield Hollow Rd
Mansfield Center, CT 06250-1314
Phone (860) 423-0877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
531CTMDEmergency Medicine Physician
000531CTMDPhysician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709337600000",
    "number": "1790907640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MANSFIELD HOLLOW RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501314",
            "telephone_number": "860-423-0877",
            "fax_number": "860-423-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MANSFIELD HOLLOW RD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501314",
            "telephone_number": "860-423-0877",
            "fax_number": "860-423-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2024-03-02",
        "certification_date": "2024-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "000531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004202008",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield Center, CT

Sources for this page

Verify at the official NPI Registry.