NPIMap

Organization Active NPI

Southwest Community Health Center

  • Counselor
  • Bridgeport, CT
National Provider Identifier
1407307119
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
SOUTHWEST COMMUNITY HEALTH CENTER
Practice address
1046 Fairfield Ave
Bridgeport, CT 06605
Phone
(203) 332-3105
Fax
(203) 331-4716
NPI assigned
Oct 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Brian Becker, PSY.D
Title
Counselor
Phone
(203) 332-3105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary

Addresses

Primary practice location

1046 Fairfield Ave
Bridgeport, CT 06605

Mailing address

1046 Fairfield Ave
Bridgeport, CT 06605
Phone (203) 332-3105

National Provider Directory

National Provider Directory
Tax ID family
Southwest Community Health Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1046 Fairfield Ave
Bridgeport, CT 06605
Phone (203) 330-6054

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1407307119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06605",
            "telephone_number": "203-332-3105",
            "fax_number": "203-331-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 FAIRFIELD AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06605",
            "telephone_number": "203-332-3105",
            "fax_number": "203-331-4716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "203-332-3105",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 18, 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.