NPIMap

Organization Active NPI

Intercommunity, Inc.

Doing business as Outpatient Counseling Center

  • Substance Abuse Rehabilitation Facility
  • Hartford, CT
National Provider Identifier
1164580379
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
SA-0201 Issued in CT
Legal business name
INTERCOMMUNITY, INC.
Doing business as
Outpatient Counseling Center
Practice address
16 Coventry Street
Hartford, CT 06112
Phone
(860) 714-3701
Fax
(860) 714-8974
NPI assigned
Dec 4, 2006
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Kimberly L Beauregard, LCSWNPI 1053346510
Title
President & Ceo
Phone
(860) 291-1340

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X SA-0159 CT
Substance Abuse Rehabilitation Facility 324500000X SA-0201 CT Primary

Addresses

Primary practice location

16 Coventry Street
Hartford, CT 06112

Mailing address

111 Founders Plaza
Suite 1802
East Hartford, CT 06108
Phone (860) 714-3701

Other names 2

  • Outpatient Counseling Center Doing business as
  • InterCommunity Recovery Centers Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Alcohol Drug Recovery Centers Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1164580379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLAZA",
            "address_2": "SUITE 1802",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "06108",
            "telephone_number": "860-714-3701",
            "fax_number": "860-714-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 COVENTRY STREET",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06112",
            "telephone_number": "860-714-3701",
            "fax_number": "860-714-8974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCOMMUNITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "BEAUREGARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "860-291-1340",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "CT",
            "license": "SA-0159",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CT",
            "license": "SA-0201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Outpatient Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "InterCommunity Recovery Centers",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jun 16, 2018; 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.