NPIMap

Organization Active NPI

Clifford W. Beers Guidance Clinic Inc

  • Adolescent and Children Mental Health Clinic/Center
  • New Haven, CT
National Provider Identifier
1073526968
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
CLIFFORD W. BEERS GUIDANCE CLINIC INC
Practice address
93 Edwards St
New Haven, CT 06511-3933
Phone
(203) 772-1270
Fax
(203) 772-0051
NPI assigned
Aug 14, 2006
Last updated
Mar 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Authorized official

Name
Frank Lavelle
Title
Director of Project Management
Phone
(203) 772-1270

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CT
Adolescent and Children Mental Health Clinic/Center 261QM0855X CT
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X CT
Clinical Psychologist 103TC0700X CT
Clinical Social Worker 1041C0700X CT
Marriage & Family Therapist 106H00000X CT
Child & Adolescent Psychiatry Physician 2084P0804X CT

Addresses

Primary practice location

93 Edwards St
New Haven, CT 06511-3933

Mailing address

93 Edwards St
New Haven, CT 06511-3933
Phone (203) 772-1270

Other identifiers 1

IdentifierTypeStateIssuer
004039178MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230106000581 CT Part B Supplier - Clinic/Group Practice 1951771054 Receives reassigned benefits from 37 practitioners
Practice locations: New Haven, CT

National Provider Directory

National Provider Directory
Tax ID family
Clifford Beers Clinic6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

41 Marne St
Hamden, CT 06514
Phone (203) 691-9383

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646611200000",
    "number": "1073526968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 EDWARDS ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113933",
            "telephone_number": "203-772-1270",
            "fax_number": "203-772-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 EDWARDS ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113933",
            "telephone_number": "203-772-1270",
            "fax_number": "203-772-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD W. BEERS GUIDANCE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A",
        "authorized_official_last_name": "LAVELLE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "DIRECTOR OF PROJECT MANAGEMENT",
        "authorized_official_telephone_number": "203-772-1270"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004039178",
            "state": "CT"
        }
    ],
    "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 Mar 7, 2022; 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.