NPIMap

Organization Active NPI

Boys and Girls Village

  • Social Worker
  • Bridgeport, CT
National Provider Identifier
1154853307
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
10762370 Issued in CT
Legal business name
BOYS AND GIRLS VILLAGE
Practice address
170 Bennett St
Bridgeport, CT 06605-2901
Phone
(203) 980-4625
NPI assigned
Mar 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Authorized official

Name
Krista Amato
Title
Iicaps Clinician
Phone
(203) 980-4625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 10762370 CT Primary

Addresses

Primary practice location

170 Bennett St
Bridgeport, CT 06605-2901

Mailing address

170 Bennett St
Bridgeport, CT 06605-2901

National Provider Directory

National Provider Directory
Tax ID family
Boys Girls Village4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

170 Bennett St
Bridgeport, CT 06605
Phone (203) 330-6790

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490659200000",
    "number": "1154853307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 BENNETT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 BENNETT ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066052901",
            "telephone_number": "203-980-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS AND GIRLS VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2017-03-28",
        "status": "A",
        "authorized_official_last_name": "AMATO",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_title_or_position": "IICAPS CLINICIAN",
        "authorized_official_telephone_number": "203-980-4625"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "CT",
            "license": "10762370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.