NPIMap

Organization Active NPI

Shoreline Wellness Behavioral Health Outreach Inc

  • Community/Behavioral Health Agency
  • West Haven, CT
National Provider Identifier
1144723305
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
SHORELINE WELLNESS BEHAVIORAL HEALTH OUTREACH INC
Practice address
415 Main Street
West Haven, CT 06516
Phone
(203) 931-1184
Fax
(203) 931-0063
NPI assigned
Mar 14, 2018
Last updated
Mar 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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

Authorized official

Name
Dr. Cara M Powers, LPC PHDNPI 1952433591
Title
Founder & President
Phone
(203) 931-1184

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

415 Main Street
West Haven, CT 06516

Mailing address

415 Main Street
West Haven, CT 06516
Phone (203) 931-1184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220325000121 CT Part B Supplier - Clinic/Group Practice 1951796119 Receives reassigned benefits from 22 practitioners
Practice locations: West Haven, CT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520985600000",
    "number": "1144723305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MAIN STREET",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "06516",
            "telephone_number": "203-931-1184",
            "fax_number": "203-931-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MAIN STREET",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "06516",
            "telephone_number": "203-931-1184",
            "fax_number": "203-931-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE WELLNESS BEHAVIORAL HEALTH OUTREACH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-14",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "CARA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FOUNDER & PRESIDENT",
        "authorized_official_telephone_number": "203-931-1184",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LPC PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.