Active NPI
Nicolette M Banbury, NCP LPC
- Counselor
- Marlborough, CT
National Provider Identifier
1902838519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 001166
- Practice address
- 11 S Main St
Marlborough, CT 06447-1553 - Phone
- (860) 295-0396
- Fax
- (860) 295-1263
- NPI assigned
- Jul 6, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 001166 | CT | Primary |
Addresses
Primary practice location
11 S Main St
Marlborough, CT 06447-1553
Mailing address
11 S Main St
Marlborough, CT 06447-1553
Phone (860) 295-0396
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240129000130 | CT | Practitioner - Mental Health Counselor | 8527411388 | Practice locations: Marlborough, CT |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
Marlborough, CT 06447
Phone (860) 295-0396
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1166 | CT | MD | Addiction (Substance Use Disorder) Counselor |
| 001166 | CT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902838519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 S MAIN ST",
"city": "MARLBOROUGH",
"state": "CT",
"postal_code": "064471553",
"telephone_number": "860-295-0396",
"fax_number": "860-295-1263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11 S MAIN ST",
"city": "MARLBOROUGH",
"state": "CT",
"postal_code": "064471553",
"telephone_number": "860-295-0396",
"fax_number": "860-295-1263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANBURY",
"first_name": "NICOLETTE",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "NCP LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CT",
"license": "001166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marlborough, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.