Tara Ann Fornuto, MED, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

5088 Issued in CT

Practice address

148 Eastern Blvd Ste 200
Glastonbury, CT 06033-4321

Phone

(860) 815-8991

NPI assigned

Sep 26, 2019

Last updated

Jun 20, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Credentials

Master of Education

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Union Cognitive Care, PC

  dba Ellie Mental Health of Glastonbury

  • Mental Health Counselor
  • Glastonbury, CT
  • NPI 1649979832
  Medicare reassignment NPD

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1851942213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EASTERN BLVD STE 200",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334321",
            "telephone_number": "860-815-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EASTERN BLVD STE 200",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334321",
            "telephone_number": "860-815-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNUTO",
        "first_name": "TARA",
        "middle_name": "ANN",
        "credential": "MED, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "5088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Fiori, RN
• Patricia Rose Fitzgerald, PH.D.
• Andrew W Fitzsimons, DC
• Heather Flynn, PH.D.
• Jessica Follo
• Julie Forster
• Fortune Billing Services
• Fox Run Psychiatric Associates PC
• Evan Fox, MD
• Laura Wurtz Foyle, PH.D.

• Professional Counselor in Glastonbury, CT
• Providers in Glastonbury, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; 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.