Katherine Beauregard, M.A., LPC, MT-BC

Key facts

NPI

1982152096

Entity type

Individual (NPI type 1)

Primary specialty

Counselor 101Y00000X

License

3803 (CT)

Practice address

27 Duck CV
South Windsor, CT 06074-3576

Phone

(860) 338-1828

NPI assigned

Sep 18, 2016

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Arts

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 13, 2019.

{
    "created_epoch": "1474156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1982152096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 DUCK CV",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743576",
            "telephone_number": "860-338-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 DUCK CV",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743576",
            "telephone_number": "860-338-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAUREGARD",
        "first_name": "KATHERINE",
        "credential": "M.A., LPC, MT-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-18",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225A00000X",
            "taxonomy_group": "",
            "desc": "Music Therapist",
            "state": "CT",
            "license": "12576",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "CT",
            "license": "3803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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