Organization Active NPI

Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Norwalk, CT
National Provider Identifier
1144510694
Registry record updated Dec 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CONNECTICUT RENAISSANCE, INC.
Practice address
17 High St
Norwalk, CT 06851-4723
Phone
(203) 854-2915
Fax
(203) 855-6474
NPI assigned
Apr 18, 2011
Last updated
Dec 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2022

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

Authorized official

Name
Mr. Dawn Patston, LMFTNPI 1508137381
Title
Coo
Phone
(203) 336-5225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary

Addresses

Primary practice location

17 High St
Norwalk, CT 06851-4723

Mailing address

1 Waterview Dr Ste 202
Shelton, CT 06484-4368
Phone (203) 336-5225

National Provider Directory

National Provider Directory
Tax ID family
Connecticut Renaissance Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/ctrenaissance/r4/

Practitioners & affiliated clinicians

Practitioners 2

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": "1303084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669939200000",
    "number": "1144510694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WATERVIEW DR STE 202",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844368",
            "telephone_number": "203-336-5225",
            "fax_number": "203-336-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 HIGH ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514723",
            "telephone_number": "203-854-2915",
            "fax_number": "203-855-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT RENAISSANCE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-18",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "PATSTON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "203-336-5225",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.