NPIMap

Organization Active NPI

Chemical Abuse Services Agency, Inc.

  • Community/Behavioral Health Agency
  • Bridgeport, CT
National Provider Identifier
1316158256
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
SA-0139 Issued in CT
Legal business name
CHEMICAL ABUSE SERVICES AGENCY, INC.
Practice address
592 Kossuth St
Bridgeport, CT 06608-2204
Phone
(203) 339-4777
Fax
(203) 339-4110
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Authorized official

Name
Mr. Asher Delerme, MS, LADC, CCS, CCPD
Title
Executive Director
Phone
(203) 331-4728

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X SA-0139 CT Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0139 CT

Addresses

Primary practice location

592 Kossuth St
Bridgeport, CT 06608-2204

Mailing address

1124 Iranistan Ave
Bridgeport, CT 06605-1121
Phone (203) 331-4728

Other identifiers 1

IdentifierTypeStateIssuer
004175528MedicaidCT

Other names 1

  • Project Courage Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D2111361Project Courage592 Kossuth St, Bridgeport, CT 06608Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Chemical Abuse Services Agency Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

592 Kossuth St
Bridgeport, CT 06608
Phone (203) 339-4777

1124 Iranistan Ave
Bridgeport, CT 06605
Phone (203) 336-4745

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1316158256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 IRANISTAN AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066051121",
            "telephone_number": "203-331-4728",
            "fax_number": "203-873-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "592 KOSSUTH ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066082204",
            "telephone_number": "203-339-4777",
            "fax_number": "203-339-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEMICAL ABUSE SERVICES AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "DELERME",
        "authorized_official_first_name": "ASHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "203-331-4728",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS, LADC, CCS, CCPD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "SA-0139",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "0139",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004175528",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Project Courage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.