Organization Active NPI

Friends and Family Counseling Services

  • Clinical Social Worker
  • Stonington, CT
National Provider Identifier
1114061157
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005649 Issued in CT
Legal business name
FRIENDS AND FAMILY COUNSELING SERVICES
Practice address
107 Wilcox Road
Suite 111
Stonington, CT 06378-2613
Phone
(860) 572-4969
Fax
(860) 572-5767
NPI assigned
Feb 15, 2007
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Mrs. Elda Storey Chesebrough, MSW,LCSWNPI 1326182353
Title
Owner
Phone
(860) 572-4969

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 002410 CT
Clinical Social Worker 1041C0700X 005649 CT Primary
Clinical Social Worker 1041C0700X 007830 CT
Marriage & Family Therapist 106H00000X 001256 CT

Addresses

Primary practice location

107 Wilcox Road
Suite 111
Stonington, CT 06378-2613

Mailing address

107 Wilcox Road
Suite 111
Stonington, CT 06378-2613
Phone (860) 572-4969

Other identifiers 1

IdentifierTypeStateIssuer
004256849MedicaidCT

National Provider Directory

National Provider Directory

Locations

107 Wilcox Rd
Ste 111
Stonington, CT 06378
Phone (860) 572-4969

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1114061157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WILCOX ROAD",
            "address_2": "SUITE 111",
            "city": "STONINGTON",
            "state": "CT",
            "postal_code": "063782613",
            "telephone_number": "860-572-4969",
            "fax_number": "860-572-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WILCOX ROAD",
            "address_2": "SUITE 111",
            "city": "STONINGTON",
            "state": "CT",
            "postal_code": "063782613",
            "telephone_number": "860-572-4969",
            "fax_number": "860-572-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDS AND FAMILY COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "CHESEBROUGH",
        "authorized_official_first_name": "ELDA",
        "authorized_official_middle_name": "STOREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-572-4969",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW,LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002410",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005649",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007830",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004256849",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stonington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.