Family Services of Central CT, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

C-0285 Issued in CT

Legal business name

FAMILY SERVICES OF CENTRAL CT, INC.

Practice address

58 Main St
Terryville, CT 06786-5106

Phone

(860) 589-6333

Fax

(860) 589-7934

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Muradian, DPA

Title

Executive Director

Phone

(860) 826-1358

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Family Services of Central Connecticut Inc4 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.

• Family Services of Central Connecticut, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Guilford, CT
  • NPI 1033206511
  NPD tax ID
• Family Services of Central Connecticut, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Meriden, CT
  • NPI 1043307432
  NPD tax ID
• Family Services of Central Connecticut, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Hamden, CT
  • NPI 1346337748
  NPD tax ID

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164517801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 VINE ST",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060521433",
            "telephone_number": "860-223-9291",
            "fax_number": "860-223-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 MAIN ST",
            "city": "TERRYVILLE",
            "state": "CT",
            "postal_code": "067865106",
            "telephone_number": "860-589-6333",
            "fax_number": "860-589-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICES OF CENTRAL CT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MURADIAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-826-1358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "C-0285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CTGA",
            "identifier": "CTGA000438 B001124",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "77ABH0021CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "ANC1482",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey D'Andrea
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• Christy D'Aquila, CNM
• Julie A Dinice, RN
• Jennifer N. Dolecki
• Stephen J Fisher, MSW
• Fun House Pediatric Therapy Services
• Ashley Goad, MSN, APRN, FNP-BC
• Inspiring Visions Counseling Services LLC
• Kiefer Counseling LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Terryville, CT
• Providers in Terryville, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.