The Family Counseling & Mediation Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

001119 Issued in CT

Legal business name

THE FAMILY COUNSELING & MEDIATION CENTER, LLC

Practice address

435 New Haven Ave
Derby, CT 06418-2534

Phone

(203) 736-6734

Fax

(203) 736-6734

NPI assigned

May 20, 2007

Organization subpart

No

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

Authorized official

Name

Karlene Chisholm, LMFT

Title

Owner

Phone

(203) 736-6734

Specialties & licenses 2

Addresses

Other identifiers 3

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

{
    "created_epoch": "1179619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1245448323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 NEW HAVEN AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182534",
            "telephone_number": "203-736-6734",
            "fax_number": "203-736-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 NEW HAVEN AVE",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064182534",
            "telephone_number": "203-736-6734",
            "fax_number": "203-736-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY COUNSELING & MEDIATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-20",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "CHISHOLM",
        "authorized_official_first_name": "KARLENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-736-6734",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "001119",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "001119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "410001119CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "316439",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7732883",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Taafel, PA
• Laura Tarini, RPH
• Jennifer Taylor, M.D.
• Team Inc
• Pratima Thapa, MD
• The Griffin Hospital
• The Griffin Hospital
• Mark A Thimineur, MD
• Sudha Thiruvengadam, MD
• Olivia Thomas, PA-C

• Mental Health Counselor in Derby, CT
• Providers in Derby, CT by specialty
• Mental Health Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.