Active NPI
Mary Noa-Kempner, LMHC
- Professional Counselor
- Old Saybrook, CT
National Provider Identifier
1831674951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 003903
- Practice address
- 21 Farview Ave
Old Saybrook, CT 06475-2206 - Phone
- (754) 264-2959
- Fax
- (954) 357-4816
- NPI assigned
- Sep 25, 2018
- Last updated
- Oct 24, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12431779-6004 | UT | |
| Mental Health Counselor | 101YM0800X | MH3157 | FL | |
| Professional Counselor | 101YP2500X | CP5153-R | NV | |
| Professional Counselor | 101YP2500X | CC03645 | MN | |
| Professional Counselor | 101YP2500X | LPCC14742 | CA | |
| Professional Counselor | 101YP2500X | 003903 | CT | Primary |
Addresses
Primary practice location
21 Farview Ave
Old Saybrook, CT 06475-2206
Mailing address
21 Farview Ave
Old Saybrook, CT 06475-2206
Phone (754) 264-2959
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
| License | State | Type | Specialty |
|---|---|---|---|
| 12431779-6004 | UT | MD | Mental Health Counselor |
| LPCC14742 | CA | MD | Professional Counselor |
| CC03645 | MN | MD | Professional Counselor |
| CP5153-R | NV | MD | Professional Counselor |
| 003903 | CT | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TML Behavioral Health Group LLC | Current | Accepting new patients | |
| Broward County | Past | Accepting new patients |
Locations
21125 Centre Pointe Pkwy
Santa Clarita, CA 91350
Phone (554) 353-8018
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.
-
dba TML Villa Canyon
- Psychiatric Residential Treatment Facility
- Castaic, CA
- NPI 1003661737
-
dba Broward Addiction Recovery Division
- Substance Abuse Rehabilitation Facility
- Fort Lauderdale, FL
- NPI 1326171034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729728000000",
"number": "1831674951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 FARVIEW AVE",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064752206",
"telephone_number": "754-264-2959",
"fax_number": "954-357-4816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 FARVIEW AVE",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064752206",
"telephone_number": "754-264-2959",
"fax_number": "954-357-4816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOA-KEMPNER",
"first_name": "MARY",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-25",
"last_updated": "2024-10-24",
"certification_date": "2024-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "12431779-6004",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH3157",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NV",
"license": "CP5153-R",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MN",
"license": "CC03645",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "LPCC14742",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "003903",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Old Saybrook, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.