NPIMap

Organization Active NPI

Hospital of Saint Raphael

  • Addiction (Substance Use Disorder) Counselor
  • New Haven, CT
National Provider Identifier
1023371275
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
HOSPITAL OF SAINT RAPHAEL
Practice address
1294 Chapel St
2ND Floor
New Haven, CT 06511-4515
Phone
(203) 784-8750
NPI assigned
Jun 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Authorized official

Name
Dr. Jennifer Ballew, D.O
Title
Medical Director
Phone
(203) 784-8750

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

1294 Chapel St
2ND Floor
New Haven, CT 06511-4515

Mailing address

1294 Chapel St
2ND Floor
New Haven, CT 06511-4515
Phone (203) 784-8750

National Provider Directory

National Provider Directory
Tax ID family
The Hospital of Saint Raphael5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1294 Chapel St
Fl 2
New Haven, CT 06511
Phone (203) 784-8750

NPI Registry JSON

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

{
    "created_epoch": "1340323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340323200000",
    "number": "1023371275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 CHAPEL ST",
            "address_2": "2ND FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114515",
            "telephone_number": "203-784-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 CHAPEL ST",
            "address_2": "2ND FLOOR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114515",
            "telephone_number": "203-784-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL OF SAINT RAPHAEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A",
        "authorized_official_last_name": "BALLEW",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "203-784-8750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2012; 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.