NPIMap

Organization Active NPI

Cos Cob Counseling Center

  • Clinical Social Worker
  • Cos Cob, CT
National Provider Identifier
1275814147
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
005814 Issued in CT
Legal business name
COS COB COUNSELING CENTER
Practice address
132 E Putnam Ave
Suite H
Cos Cob, CT 06807-2744
Phone
(203) 962-2209
Fax
(203) 962-2209
NPI assigned
Sep 6, 2011
Last updated
Feb 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Authorized official

Name
Ms. Mary M Sullivan, LCSWNPI 1174551030
Title
Clinical Social Worker
Phone
(203) 962-2209

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 005814 CT Primary

Addresses

Primary practice location

132 E Putnam Ave
Suite H
Cos Cob, CT 06807-2744

Mailing address

132 E Putnam Ave
Suite H
Cos Cob, CT 06807-2744
Phone (203) 962-2209

Other identifiers 1

IdentifierTypeStateIssuer
11707654OtherCTCAQH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391731200000",
    "number": "1275814147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 E PUTNAM AVE",
            "address_2": "SUITE H",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072744",
            "telephone_number": "203-962-2209",
            "fax_number": "203-962-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E PUTNAM AVE",
            "address_2": "SUITE H",
            "city": "COS COB",
            "state": "CT",
            "postal_code": "068072744",
            "telephone_number": "203-962-2209",
            "fax_number": "203-962-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COS COB COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-06",
        "last_updated": "2014-02-07",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "203-962-2209",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11707654",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cos Cob, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.