Individual provider Active NPI

Laura Desantis, L.P.C.

  • Professional Counselor
  • Willimantic, CT
National Provider Identifier
1861768772
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1814 Issued in CT
Practice address
90 S Park St Ste 30
Willimantic, CT 06226-3336
Phone
(617) 594-1327
NPI assigned
Mar 25, 2012
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1814 CT Primary

Addresses

Primary practice location

90 S Park St Ste 30
Willimantic, CT 06226-3336

Mailing address

90 S Park St Ste 30
Willimantic, CT 06226-3336
Phone (617) 594-1327

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241010001933 CT Practitioner - Mental Health Counselor 2668904012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

90 S Park St
Suite 30
Willimantic, CT 06226-3336
Phone (617) 594-1327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
A Daring Voyage, LLC Professional CurrentSince Sep 3, 2024 Accepting new patients

Locations

90 S Park St
Ste 30
Willimantic, CT 06226
Phone (617) 594-1327

Interoperability endpoints

  • Direct secure messaging: laura.desantis@xdr.hhchealthdirect.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1332633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1861768772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S PARK ST STE 30",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263336",
            "telephone_number": "617-594-1327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S PARK ST STE 30",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062263336",
            "telephone_number": "617-594-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANTIS",
        "first_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "1814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.