NPIMap

Organization Active NPI

Town of Branford

Doing business as Branford Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Branford, CT
National Provider Identifier
1063437895
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
C0149 Issued in CT
Legal business name
TOWN OF BRANFORD
Doing business as
Branford Counseling Center
Practice address
342 Harbor Street
Branford, CT 06405
Phone
(203) 481-4248
Fax
(203) 483-7727
NPI assigned
Jul 13, 2006
Last updated
Feb 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Authorized official

Name
Peter Cimino, LPCNPI 1205146651
Title
Executive Director
Phone
(203) 481-4248

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 002668 CT
Clinical Social Worker 1041C0700X 005435 CT
Marriage & Family Therapist 106H00000X 1942449186 CT
Psychiatry Physician 2084P0800X 014248 CT
Child & Adolescent Psychiatry Physician 2084P0804X C01490 CT
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X C0149 CT Primary

Addresses

Primary practice location

342 Harbor Street
Branford, CT 06405

Mailing address

342 Harbor Street
Branford, CT 06405
Phone (203) 481-4248

Other identifiers 5

IdentifierTypeStateIssuer
C-0149OtherCTSTATE LIC. NUMBER
004051884MedicaidCT
191065OtherCTM.H.N./H.M.C. GRP NO.
142474OtherCTVALUE OPTS. B.H. ID NO.
ANC1650OtherCTOXFORD INS. GRP NO.

Other names 1

  • Branford Counseling Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000955 CT Part B Supplier - Clinic/Group Practice 9234020165 Receives reassigned benefits from 17 practitioners
Practice locations: Branford, CT

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Town of Bradford EMS Am2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

342 Harbor St
Branford, CT 06405
Phone (203) 481-4248

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1063437895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 HARBOR STREET",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-481-4248",
            "fax_number": "203-483-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "342 HARBOR STREET",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-481-4248",
            "fax_number": "203-483-7727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF BRANFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "CIMINO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "203-481-4248",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "002668",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005435",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "1942449186",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "014248",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "C01490",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "C0149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC. NUMBER",
            "identifier": "C-0149",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004051884",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M.H.N./H.M.C. GRP NO.",
            "identifier": "191065",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTS. B.H. ID NO.",
            "identifier": "142474",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD INS. GRP NO.",
            "identifier": "ANC1650",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Branford Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.