Child Guidance Center of Southern Connecticut, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CHILD GUIDANCE CENTER OF SOUTHERN CONNECTICUT, INC.

Practice address

103 W Broad St
Stamford, CT 06902-3713

Phone

(203) 324-6127

Fax

(203) 348-9378

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jessica L Welt, PSYD

Title

Acting Ceo/Clinical Director

Phone

(203) 324-6127

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Jessica Welt-Betensky, PSY.D.

  • Psychologist
  • New Canaan, CT
  • NPI 1245473503
  NPD

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1386701779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W BROAD ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023713",
            "telephone_number": "203-324-6127",
            "fax_number": "203-348-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W BROAD ST",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069023713",
            "telephone_number": "203-324-6127",
            "fax_number": "203-348-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD GUIDANCE CENTER OF SOUTHERN CONNECTICUT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "WELT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ACTING CEO/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "203-324-6127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "OPCC-4",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Child Guidance Center of Southern Connecticut
• Child Guidance Center of Southern Connecticut
• Child Guidance Center of Southern Connecticut
• Child Guidance Center of Southern Connecticut
• Child Guidance Center of Southern Connecticut, Inc.
• Children'S Academy CT, Inc.
• Kenneth C. Childs, D.D.S.
• Doreen Bibeau Chimblo, APRN
• Jesse Chin, OD
• Sofia Chiocconi, M,D

• Community/Behavioral Health Agency in Stamford, CT
• Providers in Stamford, 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 Jul 11, 2019; 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.