Town of Stafford

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

OPCC 77 Issued in CT

Legal business name

TOWN OF STAFFORD

Practice address

21 Hyde Park Rd
Stafford Springs, CT 06076-1507

Phone

(860) 684-4239

Fax

(860) 684-0511

NPI assigned

Feb 4, 2016

Organization subpart

No

Name

Ms. Judy Gardner, LMFTNPI 1861563314

Title

Executive Director

Phone

(860) 684-4239

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

• Stafford Family Services

  • Community/Behavioral Health Agency
  • Stafford Springs, CT
  • NPI 1811103591
  NPD tax ID
• Town of Stafford - Stafford Family Services

  • Marriage & Family Therapist
  • Stafford Springs, CT
  • NPI 1952699704
  NPD tax ID

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

• Judy K Gardner, LMFT

  • Marriage & Family Therapist
  • Hartford, CT
  • NPI 1861563314
  NPD (past) Authorized official
• Alexandrea Capo Burdick, ME.D, LPCA, NCC

  • Professional Counselor
  • Stafford Springs, CT
  • NPI 1588345425
  NPD (past)
• Rebecca Hilda Fede, LMFTA

  • Mental Health Counselor
  • Southington, CT
  • NPI 1154992709
  NPD (past)
• Bethany Lewis, LMFT-A

  • Marriage & Family Therapist
  • Stafford Springs, CT
  • NPI 1285383075
  NPD (past)
• Michelene M Longo, LADC

  • Addiction (Substance Use Disorder) Counselor
  • East Hartford, CT
  • NPI 1104263284
  NPD (past)
• Bernadina Lakshmi Van Deusen, LCSW

  • Clinical Social Worker
  • Stafford Springs, CT
  • NPI 1366224784
  NPD (past)

Tax ID family

Stafford Family Services (3 organizations share this tax ID)

• Stafford Family Services Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 4, 2016.

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1073971081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HYDE PARK ROAD",
            "city": "STAFFORD SPRINGS",
            "state": "CT",
            "postal_code": "060761507",
            "telephone_number": "860-684-4239",
            "fax_number": "860-684-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HYDE PARK RD",
            "city": "STAFFORD SPRINGS",
            "state": "CT",
            "postal_code": "060761507",
            "telephone_number": "860-684-4239",
            "fax_number": "860-684-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF STAFFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-684-4239",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "OPCC 77",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "0605",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008032687",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stafford Family Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Naufel Tajudeen, PHARMD
• Terry M. Eccles, MD, LLC
• Gabriel John Thayer, D.C.
• The Treehouse Center for Children and Families, LLC
• Time to Thrive Therapy Services, LLC
• Town of Stafford - Stafford Family Services
• Stephanie Tullock, LCSW
• Bernadina Lakshmi Van Deusen, LCSW
• Francis Vannostrand, M.D.
• William Joseph Waldman, MD

• All providers in Stafford Springs, CT
• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.