Tiffany Michelle Rollo, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

003677 Issued in CT

Practice address

680 Main St Ste 305
Watertown, CT 06795-2656

Phone

(203) 707-8962

NPI assigned

Dec 30, 2019

Last updated

Dec 30, 2019By 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

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

• Healing Space

  • Counselor
  • Bristol, CT
  • NPI 1417690579
  Medicare reassignment NPD

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1902445505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 OLD FARM RD",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 MAIN ST STE 305",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952656",
            "telephone_number": "203-707-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLO",
        "first_name": "TIFFANY",
        "middle_name": "MICHELLE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genna Riggi, LPC
• Rise Above Behavioral Group CT LLC (Rise Above Behavioral Group)
• Rise Up Behavioral Health Services LLC
• Rite Aid Pharmacy
• Kayla Rodriguez
• Allyson Lynn Rovetto, M.D.
• Stephen R Rubenstein, M.D.
• Safe Journey Counseling, LLC
• Vivian Saint-Hilaire
• Frankie Sanchez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.