Spectrum Professional Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2384 Issued in CT

Legal business name

SPECTRUM PROFESSIONAL SERVICES LLC

Practice address

77-79 Bishop St
Waterbury, CT 06704-3306

Phone

(203) 756-7987

NPI assigned

May 2, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lacey Brandon, LMSW

Title

Director

Phone

(203) 695-4917

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1013362771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77-79 BISHOP STREET",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067041443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77-79 BISHOP ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067043306",
            "telephone_number": "203-756-7987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "LACEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "203-695-4917",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "2384",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "1113",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.