Individual provider Active NPI

Runa Khawaja

  • Professional Counselor
  • New Britain, CT
National Provider Identifier
1114510609
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4598 Issued in CT
Practice address
85 Lafayette St
New Britain, CT 06051-1803
Phone
(860) 224-3642
NPI assigned
Feb 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00310700 NJ
Professional Counselor 101YP2500X 37PC00681200 NJ
Professional Counselor 101YP2500X 4598 CT Primary

Addresses

Primary practice location

85 Lafayette St
New Britain, CT 06051-1803

Mailing address

19 Grand St
Middletown, CT 06457-2705
Phone (860) 347-6971

Other practice location 1

230 E Ridgewood Ave
Paramus, NJ 07652-4142
Phone (201) 967-4000 ext. 56584

Other names 1

  • Runa Khanom Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240124002407 CT Practitioner - Mental Health Counselor 6204289440 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center IncGroup PAC ID 0547169138, 149 clinicians

Practice addresses (Care Compare)

85 Lafayette St
New Britain, CT 06051-1803
Phone (860) 224-3642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37LC00310700NJMDAddiction (Substance Use Disorder) Counselor
37PC00681200NJMDProfessional Counselor
4598CTMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stokes Counseling Services LLC Professional CurrentSince Jan 1, 2024 Accepting new patients
Community Health Center Inc Addiction (Substance Use Disorder) CurrentSince Jan 1, 2024 Accepting new patients
Community Health Center Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

16 Hillside Ave
Naugatuck, CT 06770
Phone (203) 729-0341

85 Lafayette St
New Britain, CT 06051
Phone (860) 224-3642

Interoperability endpoints

  • Direct secure messaging: runa.khawaja@chcict.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1114510609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 GRAND ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572705",
            "telephone_number": "860-347-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 LAFAYETTE ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060511803",
            "telephone_number": "860-224-3642"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 E Ridgewood Ave",
            "address_purpose": "LOCATION",
            "city": "Paramus",
            "state": "NJ",
            "postal_code": "076524142",
            "country_code": "US",
            "telephone_number": "201-967-4000 x56584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAWAJA",
        "first_name": "RUNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00310700",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00681200",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "4598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUNA",
            "last_name": "KHANOM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Britain, CT

Sources for this page

Verify at the official NPI Registry.