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CONNECTICUT JUNIOR REPUBLIC ASSOCIATION, INC.
NPI 1174644926
Clinic/Center - Adolescent and Children Mental Health in Waterbury, CT

Active since April 02, 2007CLIA 07D2311577 · Waiver
80 PROSPECT ST, WATERBURY, CT 06702(203) 757-9939 Get Directions Write a Review

NPPES record last updated: June 30, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Connecticut Junior Republic Association, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CONNECTICUT JUNIOR REPUBLIC ASSOCIATION, INC. (NPI 1174644926) is a healthcare organization registered as an adolescent and children mental health in Waterbury, Connecticut and active in the NPI registry since April 2007. The organization holds a CLIA Waiver certificate valid through September 23, 2026 and lists John F Boyd, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1174644926
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameCONNECTICUT JUNIOR REPUBLIC ASSOCIATION, INC.
Location Address80 PROSPECT STWaterbury, CT 06702-1327
Mailing Address550 Goshen Road, Po Box 161Litchfield, CT 06759-0161 · (860) 567-9423
Phone(203) 757-9939
Organization SubpartNo
Authorized OfficialJohn F BoydExecutive Director · (860) 567-9423
Enumeration DateApril 2, 2007
Last NPPES UpdateJune 30, 2008
✔ NPI 1174644926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
License✔ Licensed in CT · SA0189
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
80 PROSPECT ST, Waterbury, CT 06702
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D2311577

Connecticut Junior Republic Association · Litchfield, CT
Active · expires Sep 23, 2026
CLIA Number07D2311577
Laboratory TypeSchool/Student Health Service
Certificate Effective DateSeptember 24, 2024
Certificate Expiration DateSeptember 23, 2026
Laboratory DirectorDaniel W. Rezende
Laboratory Phone(860) 567-9423
Laboratory LocationConnecticut Junior Republic Association550 Goshen Road, Litchfield, CT 06759
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLYN ROBINSON LCSW
Social Worker (Clinical)
80 PROSPECT ST
WATERBURY, CT 06702
Naugatuck Valley Planning Region (860) 756-5153
GENESIS OTERO LCSW
Social Worker (Clinical)
80 PROSPECT ST
WATERBURY, CT 06702
Naugatuck Valley Planning Region (203) 592-5140
MISS CASSANDRA MEGAN REYES LCSW
Social Worker (Clinical)
80 PROSPECT ST
WATERBURY, CT 06702
Naugatuck Valley Planning Region (203) 757-9939
SEAN EDWARD MULLANEY LCSW
Social Worker (Clinical)
80 PROSPECT ST
WATERBURY, CT 06702
Naugatuck Valley Planning Region (203) 802-3280
JACQUELINE ARROYO
Counselor (Addiction (Substance Use Disorder))
80 PROSPECT ST
WATERBURY, CT 06702
Naugatuck Valley Planning Region (203) 757-9939
KETSIA DESTRA
Social Worker (Clinical)
80 PROSPECT ST
WATERBURY, CT 06702
Naugatuck Valley Planning Region (203) 598-8630

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Connecticut Junior Republic Association, Inc.'s NPI number?

The NPI number for Connecticut Junior Republic Association, Inc. is 1174644926. It was assigned to this organization in the NPPES registry on April 2, 2007.

Where is Connecticut Junior Republic Association, Inc. located?

Connecticut Junior Republic Association, Inc. is located at 80 Prospect St, Waterbury, CT 06702. The listed phone number is (203) 757-9939.

What is Connecticut Junior Republic Association, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adolescent and Children Mental Health, with taxonomy code 261QM0855X.

Does Connecticut Junior Republic Association, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D2311577) is associated with this NPI, valid through September 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Connecticut Junior Republic Association, Inc. was last updated on June 30, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.