Emi Fukuda

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

003650 Issued in CT

Practice address

731 Main St Ste 122
Monroe, CT 06468-2872

Phone

(203) 261-7090

NPI assigned

Jan 23, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Key Therapy LLC

  • Marriage & Family Therapist
  • Monroe, CT
  • NPI 1114393493
  Medicare reassignment NPD

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

{
    "created_epoch": "1548201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1851855910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HOMESTEAD PL # 1",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108014307",
            "telephone_number": "914-380-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 MAIN ST STE 122",
            "city": "MONROE",
            "state": "CT",
            "postal_code": "064682872",
            "telephone_number": "203-261-7090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUKUDA",
        "first_name": "EMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-23",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "CT",
            "license": "003650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Ferry, LCSW
• Kathryn Mary Firisin, MSPT, NMD
• Karen D Francis, RD, CD-N
• Jaimme Lee Franson, MSN
• Stephen Frosolone, B.S., M.S., CCC-SLP
• Chelsea Gallagher, APRN
• Alice Gancsos, APRN
• Garden of Hope Counseling LLC
• Joseph John Gariepy Sr., ND
• Deborah Gaynor, MFT

• Counseling Psychologist in Monroe, CT
• Providers in Monroe, CT by specialty
• Counseling Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.