Kali Fortuna LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1083 Issued in CT

Legal business name

KALI FORTUNA LLC

Practice address

3241 Main St
Stratford, CT 06614-4850

Phone

(203) 257-2654

Fax

(203) 283-9372

NPI assigned

May 7, 2014

Organization subpart

No

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

Authorized official

Name

Kali Fortuna, LADC, MS, NCC

Title

Counselor

Phone

(203) 257-2654

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1399420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1437569738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144850",
            "telephone_number": "203-257-2654",
            "fax_number": "203-283-9372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 MAIN ST",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144850",
            "telephone_number": "203-257-2654",
            "fax_number": "203-283-9372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALI FORTUNA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-07",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "FORTUNA",
        "authorized_official_first_name": "KALI",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "203-257-2654",
        "authorized_official_credential": "LADC, MS, NCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "1083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.