NPIMap

Organization Active NPI

Counseling Connection Training Institute, PLC

Doing business as Counseling Conection Training Institute, PLC

  • Mental Health Counselor
  • Colchester, VT
National Provider Identifier
1386777639
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0680000067 Issued in VT
Legal business name
COUNSELING CONNECTION TRAINING INSTITUTE, PLC
Doing business as
Counseling Conection Training Institute, PLC
Practice address
525 Hercules Dr
Suite 1a
Colchester, VT 05446-5993
Phone
(802) 264-5333
Fax
(802) 264-5338
NPI assigned
Mar 14, 2007
Last updated
Jul 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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

Authorized official

Name
Dr. Leora Elizabeth Black, PH.D.NPI 1003986407
Title
Clinical Director
Phone
(802) 264-5333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0680000067 VT Primary

Addresses

Primary practice location

525 Hercules Dr
Suite 1a
Colchester, VT 05446-5993

Mailing address

525 Hercules Dr
Suite 1a
Colchester, VT 05446-5993
Phone (802) 264-5333

Other identifiers 1

IdentifierTypeStateIssuer
1011097MedicaidVT

Other names 1

  • Counseling Conection Training Institute, PLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Counseling Conection Training Institute PLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468368000000",
    "number": "1386777639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 HERCULES DR",
            "address_2": "SUITE 1A",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465993",
            "telephone_number": "802-264-5333",
            "fax_number": "802-264-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HERCULES DR",
            "address_2": "SUITE 1A",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054465993",
            "telephone_number": "802-264-5333",
            "fax_number": "802-264-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING CONNECTION TRAINING INSTITUTE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2016-07-13",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "LEORA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "802-264-5333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "0680000067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011097",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Counseling Conection Training Institute, PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colchester, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.