Familylink Counseling Center LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

FAMILYLINK COUNSELING CENTER LLC

Practice address

132 Monroe Tpke Ste 3
Trumbull, CT 06611-6351

Phone

(914) 980-4724

NPI assigned

Jan 5, 2018

Last updated

Jan 5, 2018By 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

Dr. Courtney Marie Mattiace, PSY.D.

Title

Clinical Psychologist

Phone

(914) 980-4724

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515110400000",
    "number": "1194232637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 COTTAGE ST",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066112827",
            "telephone_number": "914-980-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 MONROE TPKE STE 3",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066116351",
            "telephone_number": "914-980-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILYLINK COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-01-05",
        "status": "A",
        "authorized_official_last_name": "MATTIACE",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "914-980-4724",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Adolescent and Children Mental Health Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.