CONNECTICUT COUNSELING CENTERS INC NPI 1356831960

Clinic/Center (Rehabilitation, Substance Use Disorder) in Stamford, CT

NPI 1356831960 Organization Clinic/Center Rehabilitation, Substance Use Disorder

About CONNECTICUT COUNSELING CENTERS INC

Connecticut Counseling Centers Inc is a provider established in Stamford, Connecticut specializing in clinic/center (rehabilitation, substance use disorder) . The NPI number of Connecticut Counseling Centers Inc is 1356831960 and was assigned on May 2018. The practitioner's primary taxonomy code is 261QR0405X with license number SA0567 (CT). The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Jason Bradway (Director Of Information Systems)

NPI

1356831960

Provider NameCONNECTICUT COUNSELING CENTERS INC
Provider Location Address15 COMMERCE RD LOWR 1 STAMFORD, CT 06902
Provider Mailing Address50 BROOKSIDE RD WATERBURY, CT 06708
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-18-2018
Last Update Date05-18-2018


Primary Taxonomy

Taxonomy Code261QR0405X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationRehabilitation, Substance Use Disorder
License No.SA0567
License StateCT

Business Address

CONNECTICUT COUNSELING CENTERS INC
15 COMMERCE RD LOWR 1
STAMFORD, CT
ZIP 06902
Phone: (203) 653-3808
Fax: (203) 653-3809

Get Directions


Mailing Address

CONNECTICUT COUNSELING CENTERS INC
50 BROOKSIDE RD
WATERBURY, CT
ZIP 06708
Phone: (203) 568-7466
Fax: (203) 568-7468



Authorized Official

Authorized Official Name JASON BRADWAY
Authorized Official TitleDIRECTOR OF INFORMATION SYSTEMS
Authorized Official Phone(203) 568-7466

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthC0677CTNo

Taxonomy Description: an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0677OTHER (01)CT
SA0567OTHER (01)CT

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1447741889CONNECTICUT COUNSELING CENTERS INC
Organization
Clinic/Center (Primary Care)15 COMMERCE RD LOWR 1
STAMFORD, CT 06902
(203) 653-3808

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.