SOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER
NPI 1235737735
Counselor - Mental Health in Southbury, CT
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
Specialties & Licenses 7
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southbury Adolescent And Young Adult Counseling Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
24Medicare enrollment records show 24 clinicians reassign Medicare billing to Southbury Adolescent And Young Adult Counseling Center, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 6 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 24Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Is Southbury Adolescent And Young Adult Counseling Center enrolled in Medicare?
Yes. Southbury Adolescent And Young Adult Counseling Center is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southbury Adolescent And Young Adult Counseling Center?
According to the CMS Revalidation Reassignment List (October 2026 release), 24 clinicians in 4 Medicare specialties reassign their Medicare billing to Southbury Adolescent And Young Adult Counseling Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (11), Nurse Practitioner (7) and Mental Health Counselor (5). Of these, 2 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 14 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.
# Southbury Adolescent And Young Adult Counseling Center · NPI 1235737735
Mental Health organization in Southbury, Connecticut. Organization record, active in the CMS NPPES registry since October 15, 2020.
## Identity
- **NPI:** 1235737735 (Entity type: Organization)
- **Enumerated:** October 15, 2020
- **Primary specialty:** Counselor - Mental Health · taxonomy 101YM0800X
- **Organization subpart:** No
- **Authorized official:** Brendan Stack, OWNER, LPC
## Practice location
- **Address:** 519 HERITAGE RD STE 2A5, Southbury, CT 06488-6694
- **Phone:** (203) 568-5923
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 24 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Clinical Social Worker (11), Nurse Practitioner (7), Mental Health Counselor (5); 2 practice at this address and 6 within 10 miles; [full list](https://npiprofile.com/npi/1235737735/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 3, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1235737735) · Data from the CMS NPPES public registry.