NPIMap

Organization Active NPI

Shoreline Psychiatry of Western Connecticut, LLC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Darien, CT
National Provider Identifier
1194923888
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
Legal business name
SHORELINE PSYCHIATRY OF WESTERN CONNECTICUT, LLC
Practice address
20 Old Kings Hwy S
2ND Floor
Darien, CT 06820-4521
Phone
(203) 656-1452
Fax
(203) 656-1485
NPI assigned
Jul 5, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Bart A Slond, MD
Title
President
Phone
(203) 656-1452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 364SP0808X Primary

Addresses

Primary practice location

20 Old Kings Hwy S
2ND Floor
Darien, CT 06820-4521

Mailing address

20 Old Kings Hwy S
2ND Floor
Darien, CT 06820-4521
Phone (203) 656-1452

National Provider Directory

National Provider Directory
Tax ID family
Shoreline Psychiatry of Western Connecticut LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194923888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 OLD KINGS HWY S",
            "address_2": "2ND FLOOR",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068204521",
            "telephone_number": "203-656-1452",
            "fax_number": "203-656-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 OLD KINGS HWY S",
            "address_2": "2ND FLOOR",
            "city": "DARIEN",
            "state": "CT",
            "postal_code": "068204521",
            "telephone_number": "203-656-1452",
            "fax_number": "203-656-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE PSYCHIATRY OF WESTERN CONNECTICUT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLOND",
        "authorized_official_first_name": "BART",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-656-1452",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.