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SOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER
NPI 1235737735
Counselor - Mental Health in Southbury, CT

Active since October 15, 2020
519 HERITAGE RD STE 2A5, SOUTHBURY, CT 06488(203) 568-5923 Get Directions Write a Review

NPPES record last updated: August 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 9, 2025, May 17, 2024, Dec 8, 2023 and 1 more (4 updates tracked since 2020).

About Southbury Adolescent And Young Adult Counseling Center NPPES

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

SOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER (NPI 1235737735) is a healthcare organization registered as a mental health in Southbury, Connecticut and active in the NPI registry since October 2020. The organization lists Brendan Stack, Owner, Lpc, as its authorized official.

NPPES Registry Identity

NPI1235737735
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameSOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER
Location Address519 HERITAGE RD STE 2A5Southbury, CT 06488-6694
Mailing Address127 Watertown RdMiddlebury, CT 06762-1502 · (518) 610-4528
Phone(203) 568-5923
Organization SubpartNo
Authorized OfficialBrendan StackOwner, Lpc · (518) 610-4528
Enumeration DateOctober 15, 2020
Last NPPES UpdateAugust 3, 20254 updates tracked since enumeration
NPPES CertifiedAugust 3, 2025
✔ NPI 1235737735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
519 HERITAGE RD STE 2A5, Southbury, CT 06488
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

JACOB NICHOLLS LCSW
Social Worker (Clinical)
519 HERITAGE RD STE 2A5
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (203) 568-5923
MR. BRENDAN STACK LPC, LADC
Counselor (Professional)
519 HERITAGE RD STE 2A5
SOUTHBURY, CT 06488
Naugatuck Valley Planning Region (518) 610-4528

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 Southbury Adolescent And Young Adult Counseling Center's NPI number?

The NPI number for Southbury Adolescent And Young Adult Counseling Center is 1235737735. It was assigned to this organization in the NPPES registry on October 15, 2020.

Where is Southbury Adolescent And Young Adult Counseling Center located?

Southbury Adolescent And Young Adult Counseling Center is located at 519 Heritage Rd Ste 2a5, Southbury, CT 06488. The listed phone number is (203) 568-5923.

What is Southbury Adolescent And Young Adult Counseling Center's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Southbury Adolescent And Young Adult Counseling Center was last updated on August 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.