Dougherty Professional Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

001019 Issued in CT

Legal business name

DOUGHERTY PROFESSIONAL COUNSELING, LLC

Practice address

210 State St
Meriden, CT 06450-3242

Phone

(860) 374-3005

NPI assigned

Jan 11, 2016

Organization subpart

No

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

Authorized official

Name

Shawn Dougherty, LADC

Title

Owner

Phone

(860) 374-3005

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452470400000",
    "number": "1316303019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 SILVER LN",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 STATE ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064503242",
            "telephone_number": "860-374-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGHERTY PROFESSIONAL COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2016-01-11",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-374-3005",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "001019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Meriden, CT
• Providers in Meriden, CT by specialty
• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.