Individual provider Active NPI

Lejla Abidovic, LMFTA

  • Marriage & Family Therapist
  • Waterbury, CT
National Provider Identifier
1902497191
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3310 Issued in CT
Practice address
855 Lakewood Rd
Waterbury, CT 06704-5408
Phone
(888) 793-3500
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Marriage & Family Therapist 106H00000X 3310 CT Primary

Addresses

Primary practice location

855 Lakewood Rd
Waterbury, CT 06704-5408

Mailing address

159 Worcester Rd Ste 103
Charlton, MA 01507-1677

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
I20260420001425 CT Practitioner - Marriage and Family Therapist 3173099983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheeler Clinic IncGroup PAC ID 0345147153, 105 clinicians

Practice addresses (Care Compare)

855 Lakewood Rd
Waterbury, CT 06704-5408
Phone (860) 793-3500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3310CTMDProfessional Counselor

Interoperability endpoints

  • Direct secure messaging: lejla.abidovic.p1@direct.wheelerclinic.nextgenshare.com

Organizations & group practices 8

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": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1902497191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 WORCESTER RD STE 103",
            "city": "CHARLTON",
            "state": "MA",
            "postal_code": "015071677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 LAKEWOOD RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067045408",
            "telephone_number": "888-793-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABIDOVIC",
        "first_name": "LEJLA",
        "credential": "LMFTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "3310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.