NPIMap

Organization Active NPI

Connecticut Counseling Centers, Inc

  • Primary Care Clinic/Center
  • Waterbury, CT
National Provider Identifier
1306350491
Registry record updated Nov 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
0877 Issued in CT
Legal business name
CONNECTICUT COUNSELING CENTERS, INC
Practice address
50 Brookside Rd
Waterbury, CT 06708-1402
Phone
(203) 568-7466
Fax
(203) 568-7468
NPI assigned
Nov 28, 2017
Last updated
Nov 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2017

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

Authorized official

Name
Jason Bradway
Title
Director Information Systems
Phone
(203) 568-7466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 0877 CT Primary

Addresses

Primary practice location

50 Brookside Rd
Waterbury, CT 06708-1402

Mailing address

50 Brookside Rd
Waterbury, CT 06708-1402
Phone (203) 568-7466

Other identifiers 1

IdentifierTypeStateIssuer
0877OtherCTCONNECTICUT DEPT PUBLIC HEALTH

National Provider Directory

National Provider Directory
Tax ID family
Connecticut Counseling Centers Inc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511827200000",
    "number": "1306350491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BROOKSIDE RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081402",
            "telephone_number": "203-568-7466",
            "fax_number": "203-568-7468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BROOKSIDE RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081402",
            "telephone_number": "203-568-7466",
            "fax_number": "203-568-7468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT COUNSELING CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A",
        "authorized_official_last_name": "BRADWAY",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR INFORMATION SYSTEMS",
        "authorized_official_telephone_number": "203-568-7466"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CT",
            "license": "0877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT DEPT PUBLIC HEALTH",
            "identifier": "0877",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.