VICTORIA BURBANK (NPI# 1104487586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104487586 |
| Entity Type | Individual |
| Full Name | VICTORIA BURBANK |
| Practice Address |
391 Pomfret St Putnam CT 06260-1852 |
| Mailing Address |
2 Waterside Xing Ste 401 Windsor CT 06095-1587 |
| Practice Telephone | 8609634971 |
| Practice Fax Number | 8609634979 |
| Mailing Telephone | 8607315522 |
| Mailing Fax Number | 8607315536 |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| Street Address |
391 POMFRET ST |
| City | PUTNAM |
| State | CT |
| Zip Code | 06260-1852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902899859 | Ayaz T Madraswalla | Family Medicine | 391 Pomfret St, Putnam, CT 06260-1852 | 2005-08-25 |
| 1962017913 | Allyson A Vandi | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-09-15 |
| 1881207645 | Joseph Coulanges | Licensed Practical Nurse | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-08-31 |
| 1134737125 | George Mcdonald | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-07-16 |
| 1699396994 | Ashley Carpenter | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-04-28 |
| 1114566981 | Randy N Munasami | Licensed Practical Nurse | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-12-27 |
| 1023669637 | Jordan Jones | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-09-25 |
| 1801445291 | Chelsea Scanlon | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-09-09 |
| 1528615119 | Kerri A Mccaughey | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-08-20 |
| 1831744168 | Eddy Pimental | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043838139 | Shayna Marie Robinson | Behavior Technician | 62 Providence Pike Suite E, Putnam, CT 06260 | 2020-07-06 |
| 1649896390 | Bethany Barrette | Behavior Technician | 682 Providence Pike Suite E, Putnam, CT 06260 | 2020-06-18 |
| 1902450448 | Jillian Bellman | Registered Nurse | 391 Pomfret Street, Putnam, CT 06260 | 2019-08-01 |
| 1285297390 | Jourhana Colon | Behavior Technician | 62 Providence Pike Ste E, Putnam, CT 06260 | 2019-04-16 |
| 1457839417 | Amplisound, Inc. | Hearing Instrument Specialist | 19 Quinebaug Avenue, Putnam, CT 06260 | 2018-08-01 |
| 1184095960 | Lori Bergeron | Counselor | 391 Pomret Street, Putnam, CT 06260 | 2015-10-19 |
| 1558619957 | Merinessa Macayaon Quintilla | Physical Therapist | 10 Thurber Road, Genesis - Matulaitis Nursing Home, Putnam, CT 06260 | 2012-08-16 |
| 1235496936 | Mohsin Haseeb | Internal Medicine | Day Kimball Hospital, 320 Pomfret Street, Putnam, CT 06260 | 2012-04-18 |
| 1588932529 | Lifehouse Community Care, LLC | Home Health | 554 Liberty Highway Unit 2, Putnam, CT 06260 | 2011-12-05 |
| 1942433032 | Connecticut Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 57 Providence Pike, Putnam, CT 06260 | 2009-08-24 |
| Find all providers in zip 06260 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275196677 | Kelsie Boulet-briere | Counselor | 391 Pomfret St Ste 401, Putnam, CT 06260-1852 | 2019-04-22 |
| 1184095960 | Lori Bergeron | Counselor | 391 Pomret Street, Putnam, CT 06260 | 2015-10-19 |
| 1962017913 | Allyson A Vandi | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-09-15 |
| 1134737125 | George Mcdonald | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-07-16 |
| 1699396994 | Ashley Carpenter | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-04-28 |
| 1023669637 | Jordan Jones | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-09-25 |
| 1801445291 | Chelsea Scanlon | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-09-09 |
| 1528615119 | Kerri A Mccaughey | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-08-20 |
| 1831744168 | Eddy Pimental | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-08-05 |
| 1174186571 | Leilanie Jiminez | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-04-22 |
| Find all providers in PUTNAM | ||||
Please comment or provide details below to improve the information on VICTORIA BURBANK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.