NPIMap

Organization Active NPI

Community Guidance Clinic for Central Connecticut, Inc

  • Mental Health Counselor
  • Meriden, CT
National Provider Identifier
1467500090
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
COMMUNITY GUIDANCE CLINIC FOR CENTRAL CONNECTICUT, INC
Practice address
384 Pratt St
Meriden, CT 06450
Phone
(203) 235-5767
Fax
(203) 238-2010
NPI assigned
Jan 8, 2007
Reactivated
Jul 8, 2008
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Miss Wanda Ivelisse Rodriguez
Title
Billing Administrator
Phone
(203) 235-5767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CT Primary

Addresses

Primary practice location

384 Pratt St
Meriden, CT 06450

Mailing address

384 Pratt St
Meriden, CT 06450
Phone (203) 235-5767

Other identifiers 1

IdentifierTypeStateIssuer
004039210MedicaidCT

National Provider Directory

National Provider Directory
Tax ID family
Comm Guidance Clinicfor Central CT2 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 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1467500090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "384 PRATT ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-235-5767",
            "fax_number": "203-238-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "384 PRATT ST",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "06450",
            "telephone_number": "203-235-5767",
            "fax_number": "203-238-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY GUIDANCE CLINIC FOR CENTRAL CONNECTICUT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "deactivation_date": "2008-06-03",
        "reactivation_date": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "IVELISSE",
        "authorized_official_title_or_position": "BILLING ADMINISTRATOR",
        "authorized_official_telephone_number": "203-235-5767",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004039210",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; 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.