Individual provider Active NPI

Traci Marando, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Guilford, CT
National Provider Identifier
1811181126
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
003652 Issued in CT
Practice address
800 Village Walk Ste 241
Guilford, CT 06437-2762
Phone
(203) 747-5282
Fax
(203) 230-1102
NPI assigned
Aug 29, 2007
Last updated
May 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 003652 CT Primary

Addresses

Primary practice location

800 Village Walk Ste 241
Guilford, CT 06437-2762

Mailing address

800 Village Walk Ste 241
Guilford, CT 06437-2762
Phone (203) 747-5282

Other identifiers 2

IdentifierTypeStateIssuer
067124OtherCTCT. STATE LICENSE
2007003895OtherCTANCC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
003652CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Psychiatric Services, LLC Current Accepting new patients

Locations

800 Village Walk
Guilford, CT 06437
Phone (203) 430-1949

1 Evergreen Ave
Ste 34
Hamden, CT 06518
Phone (203) 376-0220

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, 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": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1811181126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 VILLAGE WALK STE 241",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372762",
            "telephone_number": "203-747-5282",
            "fax_number": "203-230-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 VILLAGE WALK STE 241",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064372762",
            "telephone_number": "203-747-5282",
            "fax_number": "203-230-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARANDO",
        "first_name": "TRACI",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-29",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "003652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT. STATE LICENSE",
            "identifier": "067124",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "2007003895",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Guilford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; 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.