Courage Counseling Center

Key facts

NPI

1013379767

Entity type

Organization (NPI type 2)

Primary specialty

Community/Behavioral Health Agency 251S00000X

License

002893 (CT)

Legal business name

COURAGE COUNSELING CENTER

Practice address

1268 Main St Ste 106
Newington, CT 06111-3043

Phone

(203) 952-1900

NPI assigned

Mar 22, 2016

Organization subpart

No

Authorized official

Name

Mr. Jeffrey Ambroise, LPC NPI 1326388257

Title

Owner/Manager

Phone

(203) 952-1900

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Ambroise, LPC Professional Counselor · Newington, CT · NPI 1326388257
  Medicare reassignment NPD Authorized official CT

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CT

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 22, 2016.

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1013379767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 TANGLEWOOD LN",
            "city": "BOLTON",
            "state": "CT",
            "postal_code": "060437820",
            "telephone_number": "203-952-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 MAIN ST STE 106",
            "city": "NEWINGTON",
            "state": "CT",
            "postal_code": "061113043",
            "telephone_number": "203-952-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURAGE COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "AMBROISE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "203-952-1900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "002893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Newington, CT · Community/Behavioral Health Agency in Connecticut