NPIMap

Organization Active NPI

Coastal Connecticut Counseling LLC

  • Marriage & Family Therapist
  • Southport, CT
National Provider Identifier
1982076014
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1759 Issued in CT
Legal business name
COASTAL CONNECTICUT COUNSELING LLC
Practice address
49 John St Ste 102
Southport, CT 06890-1484
Phone
(203) 307-3030
Fax
(203) 255-7486
NPI assigned
Oct 28, 2015
Last updated
Oct 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Authorized official

Name
Alyssa Kolesar, LMFTNPI 1952773756
Title
Owner
Phone
(203) 307-3030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X 1759 CT Primary

Addresses

Primary practice location

49 John St Ste 102
Southport, CT 06890-1484

Mailing address

49 John St Ste 102
Southport, CT 06890-1484
Phone (203) 307-3030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160114002225 CT Part B Supplier - Clinic/Group Practice 8527361161 Receives reassigned benefits from 15 practitioners
Practice locations: Southport, CT; Milford, CT; Fairfield, CT

National Provider Directory

National Provider Directory

Locations

1 Eliot Pl
#3C
Fairfield, CT 06824

1 Eliot Pl
Fl 3
Fairfield, CT 06824
Phone (203) 307-3030

1 Eliot Pl
Ste 3
Fairfield, CT 06824

58 Wellington Rd
Milford, CT 06461
Phone (203) 307-3030

2960 Post Rd
Ste 3B2
Southport, CT 06890
Phone (203) 307-3030

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1982076014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 JOHN ST STE 102",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901484",
            "telephone_number": "203-307-3030",
            "fax_number": "203-255-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 JOHN ST STE 102",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901484",
            "telephone_number": "203-307-3030",
            "fax_number": "203-255-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CONNECTICUT COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "KOLESAR",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-307-3030",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.