Individual provider Active NPI

Elizabeth Genovese

  • Professional Counselor
  • Danbury, CT
National Provider Identifier
1902209471
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
002530 Issued in CT
Practice address
38 Old Ridgebury Rd
Danbury, CT 06810-5128
Phone
(203) 792-4515
Fax
(203) 748-2604
NPI assigned
Sep 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 002530 CT Primary

Addresses

Primary practice location

38 Old Ridgebury Rd
Danbury, CT 06810-5128

Mailing address

38 Old Ridgebury Rd
Danbury, CT 06810-5128
Phone (203) 792-4515

Other practice location 1

57 Plains Rd Ste 2C
Milford, CT 06461-2573
Phone (203) 522-6164

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
I20240329002439 CT Practitioner - Mental Health Counselor 2668810433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

900 Straits Tpke
Suite 203a
Middlebury, CT 06762-2870
Phone (203) 819-0789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002530CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Mar 1, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Mar 1, 2024 Accepting new patients
Mindscapes Counseling PLLC PastSince Jan 2, 2021 Accepting new patients
The Taylor-Austin Group, LLC Professional Past Accepting new patients

Locations

900 Straits Tpke
Ste 203A
Middlebury, CT 06762

850 Straits Tpke
Ste 201
Middlebury, CT 06762
Phone (203) 758-2296

169 Main St
Fl 3
Middletown, CT 06457
Phone (610) 618-6247

Interoperability endpoints

  • Direct secure messaging: elizabeth.genovese.1@28623.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1902209471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 OLD RIDGEBURY RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105128",
            "telephone_number": "203-792-4515",
            "fax_number": "203-748-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 OLD RIDGEBURY RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105128",
            "telephone_number": "203-792-4515",
            "fax_number": "203-748-2604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 Plains Rd Ste 2C",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "CT",
            "postal_code": "064612573",
            "country_code": "US",
            "telephone_number": "203-522-6164",
            "fax_number": "203-878-3228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENOVESE",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danbury, CT

Sources for this page

Verify at the official NPI Registry.