Individual provider Active NPI

Richard Jeffrey Kubena Jr., LPC-A

  • Professional Counselor
  • Brookfield, CT
National Provider Identifier
1922866987
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6469 Issued in CT
Practice address
2 Old New Milford Rd Ste 2a
Brookfield, CT 06804-2426
Phone
(203) 775-3820
NPI assigned
Mar 13, 2024
Last updated
Mar 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 6469 CT Primary

Addresses

Primary practice location

2 Old New Milford Rd Ste 2a
Brookfield, CT 06804-2426

Mailing address

45 Lake Rd
Columbia, CT 06237-1315
Phone (203) 744-9360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 15, 2025 through Jul 15, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8540CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Christian Counseling Center of Greater Danbury Inc CurrentSince Mar 17, 2024 Accepting new patients

Locations

2 Old New Milford Rd
Ste 2A
Brookfield, CT 06804
Phone (203) 775-3282

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1922866987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 LAKE RD",
            "city": "COLUMBIA",
            "state": "CT",
            "postal_code": "062371315",
            "telephone_number": "203-744-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OLD NEW MILFORD RD STE 2A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042426",
            "telephone_number": "203-775-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBENA",
        "first_name": "RICHARD",
        "middle_name": "JEFFREY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "6469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.