Edwin Dejesus, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003609 Issued in CT

Practice address

31 Peyton PL
Middletown, CT 06457-2339

Phone

(860) 716-3081

NPI assigned

Oct 27, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Man-Up Counseling and Mentoring Centers LLC

  • Professional Counselor
  • Middletown, CT
  • NPI 1932743879
  Medicare reassignment NPD Authorized official
• Strength LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Middletown, CT
  • NPI 1194396234
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572134400000",
    "number": "1801439427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 PEYTON PL",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572339",
            "telephone_number": "860-716-3081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 PEYTON PL",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572339",
            "telephone_number": "860-716-3081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "EDWIN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-27",
        "last_updated": "2019-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri Davis
• Judith Dawe, CRNA
• Robert Paul De Carli, PSYD
• Tasha Devi Debedin, OTR/L
• Barbara Dedman, A.P.R.N.
• Edwin Raul Dejesus
• Kyle David Delahanty, CCC-SLP
• David John Delancey, CERTIFIED ADDICTIONS
• Stacey Ann Delisle, CRNA
• Danielle F Dell'Oso, OTR/L

• Professional Counselor in Middletown, CT
• Providers in Middletown, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2019; 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.