Active NPI
Alexander Robert Brack, LPC
- Professional Counselor
- Milford, CT
National Provider Identifier
1992326144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 000696
- Practice address
- 25 Housatonic Ave
Milford, CT 06460-3417 - Phone
- (203) 693-1811
- NPI assigned
- Apr 29, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 | 000696 | CT | Primary |
Addresses
Primary practice location
25 Housatonic Ave
Milford, CT 06460-3417
Mailing address
25 Housatonic Ave
Milford, CT 06460-3417
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000696 | CT | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588118400000",
"number": "1992326144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 HOUSATONIC AVE",
"city": "MILFORD",
"state": "CT",
"postal_code": "064603417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 HOUSATONIC AVE",
"city": "MILFORD",
"state": "CT",
"postal_code": "064603417",
"telephone_number": "203-693-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACK",
"first_name": "ALEXANDER",
"middle_name": "ROBERT",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-29",
"last_updated": "2020-04-29",
"certification_date": "2020-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "000696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.