Individual provider Active NPI

Shannon Lynn Talbot, LMFT

  • Marriage & Family Therapist
  • Bristol, CT
National Provider Identifier
1811477862
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001929 Issued in CT
Practice address
420 N Main St
Bristol, CT 06010-4923
Phone
(860) 583-5858
Fax
(860) 584-9962
NPI assigned
Aug 20, 2018
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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 001929 CT Primary

Addresses

Primary practice location

420 N Main St
Bristol, CT 06010-4923

Mailing address

420 N Main St
Bristol, CT 06010-4923
Phone (860) 583-5858

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
I20240328002420 CT Practitioner - Marriage and Family Therapist 2062859846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Middlesex HospitalGroup PAC ID 5092611731, 231 clinicians

Practice addresses (Care Compare)

1 Macdonough PL
Middletown, CT 06457-3607
Phone (860) 358-4034

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001929CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Middlesex Hospital CurrentSince Feb 13, 2024 Accepting new patients
Middlesex Hospital CurrentSince Feb 13, 2024 Accepting new patients

Locations

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1811477862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104923",
            "telephone_number": "860-583-5858",
            "fax_number": "860-584-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104923",
            "telephone_number": "860-583-5858",
            "fax_number": "860-584-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALBOT",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.