JEFFREY NETTLE (MA, LPC) – Professional Counselor, NPI 1073238119

JEFFREY NETTLE (MA, LPC) is a healthcare provider. based in Shelton, Connecticut. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA, LPC. They hold a License No. 5855 (CT). The NPI Number for JEFFREY NETTLE (MA, LPC) is 1073238119

Main info

Male
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
JEFFREY NETTLE (MA, LPC)
NPI
1073238119
Phone
(203) 577-8679
Address
331 JEAN CT
Enumeration Date
11 October 2022
Last Update Date
7 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2039511858
Graduation Year
2000 (26 years ago)
PAC ID
5395180640
Group Practice PAC ID
4486996329
Professional Enrollment ID
I20240227002050
Address ID
CT064783170OX350XXGRNX403
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Digital endpointsOther names

818 MENTAL HEALTH COUNSELOR in CT

Provider Addresses for JEFFREY NETTLE (MA, LPC)

  • 331 JEAN CT

    SHELTON, CT 064843889

    Phone: (203) 577-8679

    Type: Mailing

  • 107 CHURCH HILL RD

    SANDY HOOK, CT 064821194

    Phone: (474) 323-2200

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240227002050IMental Health CounselorCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06484)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486996329View full group profile
NameSpecialtyState
Nurse PractitionerCT
Clinical Social WorkerNY
Clinical Social WorkerCT
Marriage And Family TherapistCT

Reviews

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Frequently asked questions

What federal number belongs to JEFFREY NETTLE (MA, LPC)?
The federal identifier for JEFFREY NETTLE (MA, LPC) is NPI 1073238119.
Is JEFFREY NETTLE (MA, LPC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does JEFFREY NETTLE (MA, LPC) work in?
You can think of JEFFREY NETTLE (MA, LPC) as practicing within Professional Counselor. Clinical services aligned with this taxonomy classification.
Does JEFFREY NETTLE (MA, LPC) practice in Connecticut?
You will see Shelton, Connecticut on file for JEFFREY NETTLE (MA, LPC) alongside any extra practice locations.
How can I contact JEFFREY NETTLE (MA, LPC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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