Organization Active NPI

Jeffrey F Kochiss LLC

Doing business as Support for Life

  • Marriage & Family Therapist
  • Cheshire, CT
National Provider Identifier
1841552320
Registry record updated Feb 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001297 Issued in CT
Legal business name
JEFFREY F KOCHISS LLC
Doing business as
Support for Life
Practice address
555 Highland Ave Ste 1
Cheshire, CT 06410-2255
Phone
(203) 437-2161
NPI assigned
Jun 12, 2012
Last updated
Feb 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2024

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

Authorized official

Name
Laurie Fistola
Title
Access Manager
Phone
(203) 217-6601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001297 CT Primary

Addresses

Primary practice location

555 Highland Ave Ste 1
Cheshire, CT 06410-2255

Mailing address

408 Highland Ave
Cheshire, CT 06410-2525

Other names 1

  • Support for Life Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241104000828 CT Part B Supplier - Clinic/Group Practice 6608309208 Receives reassigned benefits from 1 practitioner
Practice locations: Cheshire, CT

National Provider Directory

National Provider Directory

Locations

408 Highland Ave
Cheshire, CT 06410
Phone (860) 729-0252

555 Highland Ave
Ste 1
Cheshire, CT 06410
Phone (203) 437-2161

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708732800000",
    "number": "1841552320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGHLAND AVE",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 HIGHLAND AVE STE 1",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102255",
            "telephone_number": "203-437-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY F KOCHISS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-12",
        "last_updated": "2024-02-24",
        "certification_date": "2024-02-24",
        "status": "A",
        "authorized_official_last_name": "FISTOLA",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "ACCESS MANAGER",
        "authorized_official_telephone_number": "203-217-6601"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Support for Life",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.