NPIMap

Organization Active NPI

Community Renewal Team

  • Pastoral Counselor
  • Hartford, CT
National Provider Identifier
1124397518
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
License
007737 Issued in CT
Legal business name
COMMUNITY RENEWAL TEAM
Practice address
1921 Park St
Hartford, CT 06106-2118
Phone
(860) 951-8770
Fax
(860) 233-2796
NPI assigned
Dec 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Authorized official

Name
Larry Alonzo Watts, LCSW
Title
Clinician
Phone
(860) 951-8770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP1600X 007737 CT Primary

Addresses

Primary practice location

1921 Park St
Hartford, CT 06106-2118

Mailing address

1921 Park St
Hartford, CT 06106-2118
Phone (860) 951-8770

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1124397518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 PARK ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062118",
            "telephone_number": "860-951-8770",
            "fax_number": "860-233-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 PARK ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061062118",
            "telephone_number": "860-951-8770",
            "fax_number": "860-233-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RENEWAL TEAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "ALONZO",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "860-951-8770",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Pastoral",
            "state": "CT",
            "license": "007737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.