Connectic Ut Mental Health Services

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

002211 Issued in CT

Legal business name

CONNECTIC UT MENTAL HEALTH SERVICES

Practice address

270 Farmington Ave
Building One
Farmington, CT 06032-1909

Phone

(860) 677-5570

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Dana Kriscenski

Title

Administrative Assistant

Phone

(860) 677-5570

Specialties & licenses 1

Addresses

Other names 1

• GERIATRIC MENTAL HEALTH SERVICES Former legal business name

Locations

Practitioners 1

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

• Maryellen S Garval, LCSW

  • Clinical Social Worker
  • Farmington, CT
  • NPI 1306880232
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1073565198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MIDDLEFIELD DR",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071245",
            "telephone_number": "186-023-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 FARMINGTON AVE",
            "address_2": "BUILDING ONE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060321909",
            "telephone_number": "860-677-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTIC UT MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "KRISCENSKI",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "18606775570",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "002211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GERIATRIC MENTAL HEALTH SERVICES",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Farmington, CT
• Providers in Farmington, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.