Active NPI
Eric Stillman
- Professional Counselor
- Bloomfield, CT
National Provider Identifier
1942793344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 46.005871
- Practice address
- 693 Bloomfield Ave
Bloomfield, CT 06002-2489 - Phone
- (860) 243-6584
- Fax
- (860) 243-6591
- NPI assigned
- Jun 11, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 46.005871 | CT | Primary |
Addresses
Primary practice location
693 Bloomfield Ave
Bloomfield, CT 06002-2489
Mailing address
995 Day Hill Rd
Windsor, CT 06095-1722
Phone (860) 731-5522
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
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
39 Mill St
Suite 4
Berlin, CT 06037-2359
Phone (860) 288-7017
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46.005871 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kerith Brook Counseling, LLC | Current | Accepting new patients |
Locations
39 Mill St
Ste 4
Berlin, CT 06037
Phone (860) 288-7017
9 Cody St
West Hartford, CT 06110
Phone (860) 288-7017
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 and National Provider Directory roles.
-
- Clinic/Center
- West Hartford, CT
- NPI 1417711847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1942793344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "995 DAY HILL RD",
"city": "WINDSOR",
"state": "CT",
"postal_code": "060951722",
"telephone_number": "860-731-5522",
"fax_number": "860-731-5536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "693 BLOOMFIELD AVE",
"city": "BLOOMFIELD",
"state": "CT",
"postal_code": "060022489",
"telephone_number": "860-243-6584",
"fax_number": "860-243-6591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILLMAN",
"first_name": "ERIC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-11",
"last_updated": "2023-01-25",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "46.005871",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; 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.