NPIMap

Organization Active NPI

Old Saybrook Youth and Family Services

  • Clinical Social Worker
  • Old Saybrook, CT
National Provider Identifier
1164699914
Registry record updated May 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
003682 Issued in CT
Legal business name
OLD SAYBROOK YOUTH AND FAMILY SERVICES
Practice address
322 Main St
Old Saybrook, CT 06475-2350
Phone
(860) 395-3190
NPI assigned
May 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2008

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

Authorized official

Name
Larry Freundlich
Title
Director
Phone
(860) 395-3190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 003682 CT Primary

Addresses

Primary practice location

322 Main St
Old Saybrook, CT 06475-2350

Mailing address

322 Main St
Old Saybrook, CT 06475-2350
Phone (860) 395-3190

National Provider Directory

National Provider Directory
Tax ID family
Old Saybrook Youth and Family Services4 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.

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210550400000",
    "number": "1164699914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 MAIN ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752350",
            "telephone_number": "860-395-3190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 MAIN ST",
            "city": "OLD SAYBROOK",
            "state": "CT",
            "postal_code": "064752350",
            "telephone_number": "860-395-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD SAYBROOK YOUTH AND FAMILY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2008-05-12",
        "status": "A",
        "authorized_official_last_name": "FREUNDLICH",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "860-395-3190"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Saybrook, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2008; 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.