Angelo M. Farenga, LPC
Individual provider Active NPI Mental Health Counselor · Watertown, CT
NPI 1811909401 · NPPES record last updated Oct 25, 2013
Key facts
- NPI
- 1811909401
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 000118 (CT)
- Practice address
- 27 Siemon Company Dr
Suite 310W
Watertown, CT 06795-2654 - Phone
- (860) 417-2005
- Fax
- (860) 730-6225
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
27 Siemon Company Dr
Watertown, CT 06795-2654
Phone (860) 417-2005
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240218000069 | CT | Practitioner - Mental Health Counselor | 4688018674 | Practice locations: Watertown, CT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000118 | CT | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 000118 | CT | Yes |
Addresses
Primary practice location
27 Siemon Company Dr
Suite 310W
Watertown, CT 06795-2654
Mailing address
PO Box 186
Watertown, CT 06795-0186
Phone (860) 417-2006
NPI Registry JSON
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382659200000",
"number": "1811909401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 186",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "067950186",
"telephone_number": "860-417-2006",
"fax_number": "860-730-6225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27 SIEMON COMPANY DR",
"address_2": "SUITE 310W",
"city": "WATERTOWN",
"state": "CT",
"postal_code": "067952654",
"telephone_number": "860-417-2005",
"fax_number": "860-730-6225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FARENGA",
"first_name": "ANGELO",
"middle_name": "M.",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2013-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CT",
"license": "000118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, CT
- Matthew Egan
- Trisha Erdman
- Miranda Erikson
- Preshia Heather Evans
- Kayla Fac
- Peter Anthony Ferrante
- Matthew Ferrari
- Jacqueline Leigh Ferrell
- James F Flint
- Kathryn Flodquist
All providers in Watertown, CT · Mental Health Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 25, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.