Asd Support Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

007775 Issued in CT

Legal business name

ASD SUPPORT SERVICES LLC

Doing business as

ASD Center for Therapeutic Services

Practice address

415 Killingworth Rd
Suite 9a/B
Higganum, CT 06441-4370

Phone

(860) 532-0604

Fax

(860) 322-4723

NPI assigned

Dec 18, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Sean Carlin, LCSW

Title

Founder/Director of Clinical Servic

Phone

(860) 532-0604

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ASD Center for Therapeutic Services Doing business as

Locations

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

{
    "created_epoch": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1174921431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 KILLINGWORTH RD",
            "address_2": "SUITE 9A/B",
            "city": "HIGGANUM",
            "state": "CT",
            "postal_code": "064414370",
            "telephone_number": "860-532-0604",
            "fax_number": "860-322-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 KILLINGWORTH RD",
            "address_2": "SUITE 9A/B",
            "city": "HIGGANUM",
            "state": "CT",
            "postal_code": "064414370",
            "telephone_number": "860-532-0604",
            "fax_number": "860-322-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASD SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "CARLIN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "SEAN",
        "authorized_official_title_or_position": "FOUNDER/DIRECTOR OF CLINICAL SERVIC",
        "authorized_official_telephone_number": "860-532-0604",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "007775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI#",
            "identifier": "1255606075",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ASD Center for Therapeutic Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Social Worker in Higganum, CT
• Providers in Higganum, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.