NPIMap

Organization Active NPI

Cassidy Counseling Center

  • Mental Health Counselor
  • Waterbury, CT
National Provider Identifier
1083206809
Registry record updated Feb 4, 2021
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Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CASSIDY COUNSELING CENTER
Practice address
678 Chase Pkwy
Waterbury, CT 06708-3050
Phone
(203) 757-9357
Fax
(203) 757-0371
NPI assigned
Feb 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2021

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

Authorized official

Name
Rose Brunette-Jimenez, LPC
Title
LPC
Phone
(203) 757-9357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

678 Chase Pkwy
Waterbury, CT 06708-3050

Mailing address

678 Chase Pkwy
Waterbury, CT 06708-3050
Phone (203) 757-9357

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1083206809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083050",
            "telephone_number": "203-757-9357",
            "fax_number": "203-757-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 CHASE PKWY",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067083050",
            "telephone_number": "203-757-9357",
            "fax_number": "203-757-0371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASSIDY COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "BRUNETTE-JIMENEZ",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "203-757-9357",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.