NPIMap

Organization Active NPI

Hockanum Valley Community Council, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Vernon, CT
National Provider Identifier
1336179480
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
0466 Issued in CT
Legal business name
HOCKANUM VALLEY COMMUNITY COUNCIL, INC.
Practice address
27 Naek Rd
Suite 4
Vernon, CT 06066-3965
Phone
(860) 872-9825
Fax
(860) 870-9384
NPI assigned
Jul 4, 2006
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Celia Wheeler
Title
Office Manager
Phone
(860) 872-9825

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 0466 CT Primary

Addresses

Primary practice location

27 Naek Rd
Suite 4
Vernon, CT 06066-3965

Mailing address

27 Naek Rd
Suite 4
Vernon, CT 06066-3965
Phone (860) 872-9825

Other practice location 1

18 Oneco St Ste 2
Norwich, CT 06360-3440
Phone (860) 872-9825

Other identifiers 2

IdentifierTypeStateIssuer
C01720OtherCTMEDICARE GROUP
004140498MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040601000823 CT Part B Supplier - Clinic/Group Practice 3476534017 Receives reassigned benefits from 11 practitioners
Practice locations: Vernon, CT

National Provider Directory

National Provider Directory

Locations

27 Naek Rd
Ste 4
Vernon Rockville, CT 06066
Phone (860) 872-9825

Practitioners & affiliated clinicians

Practitioners 12

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1336179480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 NAEK RD",
            "address_2": "SUITE 4",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060663965",
            "telephone_number": "860-872-9825",
            "fax_number": "860-870-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 NAEK RD",
            "address_2": "SUITE 4",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060663965",
            "telephone_number": "860-872-9825",
            "fax_number": "860-870-9384"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18 Oneco St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Norwich",
            "state": "CT",
            "postal_code": "063603440",
            "country_code": "US",
            "telephone_number": "860-872-9825",
            "fax_number": "860-870-7940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOCKANUM VALLEY COMMUNITY COUNCIL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "860-872-9825"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "0466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "C01720",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004140498",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.