Bryan D McCloskey, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3231 Issued in CT

Practice address

21 Montauk Ave
New London, CT 06320-4906

Phone

(860) 271-4700

Fax

(860) 271-4797

NPI assigned

Apr 20, 2015

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

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

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Stony Creek Wellness Group, LLCGroup PAC ID 3072896380, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/soundcommunityservices/r4/

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.

• Stony Creek Wellness Group, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Guilford, CT
  • NPI 1598209116

  Professional

  Medicare reassignment Care Compare group NPD
• Sound Community Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New London, CT
  • NPI 1396700886
  NPD (past)

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1982091781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 390",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063606484",
            "telephone_number": "860-271-4715",
            "fax_number": "860-271-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-271-4700",
            "fax_number": "860-271-4797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1491 Main St",
            "address_purpose": "LOCATION",
            "city": "Willimantic",
            "state": "CT",
            "postal_code": "062261914",
            "country_code": "US",
            "telephone_number": "860-456-3215",
            "fax_number": "860-423-3351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCLOSKEY",
        "first_name": "BRYAN",
        "middle_name": "D",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3231",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louis Mazzarelli, M.D.
• Sonja Mazzulli, O.T.
• Katherine McBurney, LCSW
• Lynn A McCaffrey, LCSW
• Jamar McClellan
• Molly Michelle McCormick
• Quinn McDermott, LMFT
• Alijah McGaha
• Judith Ann McGannon, CRNA
• Meredith McGinn, LPC

• Professional Counselor in New London, CT
• Providers in New London, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.

Verify at the official NPI Registry.