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BOYS & GIRLS VILLAGE
NPI 1477583581
Clinic/Center - Adolescent and Children Mental Health in Milford, CT

Active since July 04, 2006CLIA Certified · 3 labs
528 WHEELERS FARMS RD, MILFORD, CT 06461(203) 877-0300(203) 876-0076 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Boys & Girls Village NPPES

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

BOYS & GIRLS VILLAGE (NPI 1477583581) is a healthcare organization registered as an adolescent and children mental health in Milford, Connecticut and active in the NPI registry since July 2006. The organization holds 3 active CLIA laboratory certificates and lists L. Kenneth Fellenbaum, Ceo, as its authorized official.

NPPES Registry Identity

NPI1477583581
Entity TypeOrganization
Primary Taxonomy261QM0855X
Legal Business NameBOYS & GIRLS VILLAGE
Location Address528 WHEELERS FARMS RDMilford, CT 06461-1847
Mailing Address528 Wheelers Farms RdMilford, CT 06461-1847 · (203) 877-0300 · Fax (203) 876-0076
Phone(203) 877-0300
Fax(203) 876-0076
Organization SubpartNo
Authorized OfficialL. Kenneth FellenbaumCeo · (203) 877-0300
Enumeration DateJuly 4, 2006
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1477583581 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Adolescent and Children Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0855X
Licenses✔ Licensed in CT · CPA-40✔ Licensed in CT · EDT-10✔ Licensed in CT · OPCC-38
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.
Also ListedPsychiatric Residential Treatment FacilityTaxonomy 323P00000X · License CCF/TS 17 (CT)
528 WHEELERS FARMS RD, Milford, CT 06461
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Other Identifiers 1

Medicaid004189173-00CT

CLIA Laboratory Certificates CMS CLIA 3

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 07D2262853

Boys & Girls Village Inc- Milford · Milford, CT
Active · expires Jun 19, 2028
CLIA Number07D2262853
Laboratory TypeHome Health Agency
Certificate Effective DateJune 20, 2026
Certificate Expiration DateJune 19, 2028
Laboratory DirectorKimberly Shaunesey
Laboratory Phone(203) 877-0300
Laboratory LocationBoys & Girls Village Inc- Milford528 Wheelers Farm Rd, Milford, CT 06461
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 07D2180770

Boys & Girls Village, Inc · Norwalk, CT
Active · expires Mar 18, 2028
CLIA Number07D2180770
Laboratory TypeHome Health Agency
Certificate Effective DateMarch 19, 2026
Certificate Expiration DateMarch 18, 2028
Laboratory DirectorKimberly Shaunesey
Laboratory Phone(203) 877-0300
Laboratory LocationBoys & Girls Village, Inc111 East Ave, Suite 207, Norwalk, CT 06851
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 07D2180467

Boys & Girls Village Inc 170 Bennett St Bridgeport Location · Bridgeport, CT
Active · expires Mar 15, 2028
CLIA Number07D2180467
Laboratory TypeHome Health Agency
Certificate Effective DateMarch 16, 2026
Certificate Expiration DateMarch 15, 2028
Laboratory DirectorKimberly Shaunesey
Laboratory Phone(203) 877-0300
Laboratory LocationBoys & Girls Village Inc 170 Bennett St Bridgeport Location170 Bennett St, Bridgeport, CT 06605
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

CARRA CONLAN LCSW
Social Worker (Clinical)
528 WHEELERS FARMS RD
MILFORD, CT 06461
South Central Connecticut Planning Region (203) 713-7728
JASMINE FORD
Case Manager/Care Coordinator
528 WHEELERS FARMS RD
MILFORD, CT 06461
South Central Connecticut Planning Region (203) 877-0300
LUCY M HERNANDEZ
Counselor (Professional)
528 WHEELERS FARMS RD
MILFORD, CT 06461
South Central Connecticut Planning Region (203) 993-4507
JAMIE L WRIGHT MS, OTR/L
Occupational Therapist
528 WHEELERS FARMS RD
MILFORD, CT 06461
South Central Connecticut Planning Region (203) 877-0300
CHRISTOPHER ERIKSSON LPC
Counselor (Professional)
528 WHEELERS FARMS RD
MILFORD, CT 06461
South Central Connecticut Planning Region (203) 877-0300

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 Boys & Girls Village's NPI number?

The NPI number for Boys & Girls Village is 1477583581. It was assigned to this organization in the NPPES registry on July 4, 2006.

Where is Boys & Girls Village located?

Boys & Girls Village is located at 528 Wheelers Farms Rd, Milford, CT 06461. The listed phone number is (203) 877-0300.

What is Boys & Girls Village's specialty?

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

Does Boys & Girls Village hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Boys & Girls Village was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.