NPIMap

Organization Active NPI

Family Centered Services of CT

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1548305709
Registry record updated Feb 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
004253960 Issued in CT
Legal business name
FAMILY CENTERED SERVICES OF CT
Practice address
235 Nicoll St
New Haven, CT 06511-2670
Phone
(203) 624-2600
Fax
(203) 562-6232
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2013

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

Authorized official

Name
Jacquelyn Farrell, LCSWNPI 1144385907
Title
Assistant Director
Phone
(203) 624-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 004253960 CT Primary

Addresses

Primary practice location

235 Nicoll St
New Haven, CT 06511-2670

Mailing address

235 Nicoll St
New Haven, CT 06511-2670
Phone (203) 624-2600

Other identifiers 1

IdentifierTypeStateIssuer
004253960MedicaidCT

Other names 1

  • COORDINATING COUNCIL FOR CHILDREN IN CRISIS Former legal business name

National Provider Directory

National Provider Directory

Locations

235 Nicoll St
New Haven, CT 06511
Phone (203) 624-2600

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1548305709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 NICOLL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112670",
            "telephone_number": "203-624-2600",
            "fax_number": "203-562-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 NICOLL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112670",
            "telephone_number": "203-624-2600",
            "fax_number": "203-562-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CENTERED SERVICES OF CT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "FARRELL",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "203-624-2600",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004253960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004253960",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COORDINATING COUNCIL FOR CHILDREN IN CRISIS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.