Nicole Ventura Roach, MA, LPC, RDT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6384 Issued in CT

Practice address

85 Willow St Ste 7
New Haven, CT 06511-2696

Phone

(203) 871-1876

NPI assigned

May 21, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Ventura Roach Capital LLC

  dba Dramatic Action Therapy

  • Mental Health Counselor
  • Wallingford, CT
  • NPI 1528811569

  Drama Therapist

  NPD Authorized official

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1942049887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BIRCH DR",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064925210",
            "telephone_number": "201-669-0057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WILLOW ST STE 7",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112696",
            "telephone_number": "203-871-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA ROACH",
        "first_name": "NICOLE",
        "credential": "MA, LPC, RDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101200000X",
            "taxonomy_group": "",
            "desc": "Drama Therapist",
            "state": null,
            "license": "834",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "6384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee J Venancio, P.A.
• Lucia A Venditti, LCSW
• Prathiba Venkatachalapathy
• Arjun Krishna Venkatesh, M.D.
• Pamela Ventola, PHD
• Jessica Ventura
• Joanne Delone Verdiner, LPC
• Alyssa Vereneau, PT, DPT
• Vinu Verghese, DO
• Sharon Verity, PAC

• Mental Health Counselor in New Haven, CT
• Providers in New Haven, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.