CONNECTICUT JUNIOR REPUBLIC ASSOCIATION, INC.
NPI 1174644926
Clinic/Center - Adolescent and Children Mental Health in Waterbury, CT
NPI Status: Active since April 02, 2007
Contact Information
80 PROSPECT ST
WATERBURY, CT
ZIP 06702
Phone: (203) 757-9939
- Organization
- Clinic/Center
- Adolescent and Children Mental Health
- CLIA Number: 07D2311577
- CLIA Cert. Type: School/Student Health Service
- CLIA Exp. Date: 09-23-2026
About CONNECTICUT JUNIOR REPUBLIC ASSOCIATION, INC.
This page provides the complete NPI Profile along with additional information for Connecticut Junior Republic Association, Inc., a provider established in Waterbury, Connecticut operating as a Clinic/center, focusing in adolescent and children mental health . The healthcare provider is registered in the NPI registry with number 1174644926 assigned on April 2007. The practitioner's primary taxonomy code is 261QM0855X with license number SA0189 (CT). The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Mr. John F Boyd (Executive Director)
- NPI
- 1174644926
- Provider Name
- CONNECTICUT JUNIOR REPUBLIC ASSOCIATION, INC.
- Entity Type
- Organization
- Location Address
- 80 PROSPECT ST WATERBURY, CT 06702
- Location Phone
- (203) 757-9939
- Mailing Address
- 550 GOSHEN ROAD PO BOX 161 LITCHFIELD, CT 06759
- Mailing Phone
- (860) 567-9423
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-02-2007
- Last Update Date
- 06-30-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Adolescent and Children Mental Health
- Taxonomy Code
- 261QM0855X
- Type
- Ambulatory Health Care Facilities
- License No.
- SA0189
- License State
- CT
- Taxonomy Description
- 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.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 07D2311577
- Facility Type
- School/Student Health Service
- Certificate Effective Date
- September 24, 2024
- Certificate Expiration Date
- September 23, 2026
- Laboratory Director
- DANIEL W. REZENDE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Connecticut Junior Republic Association, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1174644926, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174644926, enumerated as an "organization" on April 02, 2007.
The provider is located at 80 PROSPECT ST WATERBURY, CT 06702 and the phone number is (203) 757-9939.
Clinic/Center with taxonomy code 261QM0855X and a focus in Adolescent and Children Mental Health.
