Intercommunity, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

INTERCOMMUNITY, INC.

Practice address

828 Sullivan Ave FL 1
South Windsor, CT 06074-2093

Phone

(860) 569-5900

Fax

(860) 310-2127

NPI assigned

Jul 10, 2019

Last updated

Jul 10, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

INTERCOMMUNITY, INC.As reported in NPPES

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

Authorized official

Name

Kimberly L BeauregardNPI 1053346510

Title

Ceo

Phone

(860) 569-5900

Specialties & licenses 3

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Intercommunity Mental H6 organizations share this tax ID, including this one

Part of

Intercommunity Mental H

Other organizations with this tax ID 5

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

• Intercommunity Mental Health Group

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wethersfield, CT
  • NPI 1245430891
  NPD tax ID
• Intercommunity, Inc.

  • Primary Care Clinic/Center
  • East Hartford, CT
  • NPI 1073548533
  NPD tax ID
• Intercommunity, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1588095657
  NPD tax ID
• Intercommunity, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1962896548
  NPD tax ID
• Intercommunity, Inc.

  • Student Health Clinic/Center
  • East Hartford, CT
  • NPI 1982120911
  NPD tax ID

Locations

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.

• Kimberly L Beauregard, LCSW

  • Social Worker
  • East Hartford, CT
  • NPI 1053346510
  Authorized official Same address or phone

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1497307573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FOUNDERS PLZ STE 1802",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061088301",
            "telephone_number": "860-569-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 SULLIVAN AVE FL 1",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742093",
            "telephone_number": "860-569-5900",
            "fax_number": "860-310-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCOMMUNITY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTERCOMMUNITY, INC.",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "BEAUREGARD",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-569-5900"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Hopkins, LPC AND LADC
• Sarah M Hornberger
• Steven C Hutt
• Igniting Hope Counseling Services, LLC
• Innovative TMS LLC
• International Institute for Professional Development, LLC
• Susada Inthavong, APRN
• Krista Iwanicki
• Quincy Edwige Jacques
• Gene T Jay, PHARMD

• Federally Qualified Health Center (FQHC) in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Federally Qualified Health Center (FQHC) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.