Foundations Counseling, LLC

Primary specialty

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

License

003065 Issued in CT

Legal business name

FOUNDATIONS COUNSELING, LLC

Practice address

2911 Dixwell Ave Ste 105
Hamden, CT 06518-3130

Phone

(860) 987-7408

NPI assigned

Apr 17, 2018

Last updated

Aug 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chrystal L Shoup Daquila, LPC

Title

Licensed Professional Counselor

Phone

(860) 987-7408

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

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.

• Chrystal L Shoup

  • Professional Counselor
  • Hamden, CT
  • NPI 1184010357
  Medicare reassignment NPD

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1184111023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BARRETT ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065172503",
            "telephone_number": "860-987-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 DIXWELL AVE STE 105",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183130",
            "telephone_number": "860-987-7408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 Barrett St",
            "address_purpose": "LOCATION",
            "city": "Hamden",
            "state": "CT",
            "postal_code": "065172503",
            "country_code": "US",
            "telephone_number": "860-987-7408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOUNDATIONS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-17",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "SHOUP DAQUILA",
        "authorized_official_first_name": "CHRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "860-987-7408",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "003065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher J Flick
• Sandra Dawn Fomenko, MSN, AGPCNP-BC, CPNP
• Footprint Initiative, LLC
• Charity D Ford, LMSW
• Catherine K Forrest, APRN
• Ann Marie Fowler, APRN
• Jaclyn A Francis, PA-C
• Amber G Frank
• Karlene Fraser-Brown
• Kenneth Fratarcangeli, DMD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Hamden, CT
• Providers in Hamden, 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 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.