Bernice V Malachi

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1310 Main St
Willimantic, CT 06226-1910

Phone

(860) 731-5522

Fax

(860) 731-5536

NPI assigned

Apr 3, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Intercommunity, Inc.

  • Primary Care Clinic/Center
  • East Hartford, CT
  • NPI 1073548533
  Medicare reassignment NPD
• Zeal 4 Life Center, LLC

  • Mental Health Counselor
  • Glastonbury, CT
  • NPI 1528864717
  NPD Authorized official
• Intercommunity, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1962896548
  NPD

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1891113056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951588",
            "telephone_number": "860-697-3351",
            "fax_number": "607-315-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261910",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALACHI",
        "first_name": "BERNICE",
        "middle_name": "V",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235918",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Azra Lupacchino, LPC
• Virginia Lyon, LCSW
• Vincent I. Macandrew Jr., M.D.
• Gina K Maccarone, RN
• Shona K Maddocks, LCSW
• Susan J. Mancuso, OTR
• Matthew E Mannarino, LCSW
• Mansfield Cardiovascular Care LLC
• Jacqueline Mary Manthous
• Ruth E. Marcial, PSY. D.

• Professional Counselor in Willimantic, CT
• Providers in Willimantic, 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 18, 2021; 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.