NPIMap

Organization Active NPI

CT Psychological & Assessment Center,LLC

  • Mental Health Counselor
  • Wethersfield, CT
National Provider Identifier
1548558232
Registry record updated Jul 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001997 Issued in CT
Legal business name
CT PSYCHOLOGICAL & ASSESSMENT CENTER,LLC
Practice address
61 Wells Rd
Wethersfield, CT 06109-3043
Phone
(860) 372-4811
Fax
(860) 372-4812
NPI assigned
Jul 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2011

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

Authorized official

Name
Lilliam Martinez, MANPI 1255632311
Title
Owner
Phone
(860) 904-3444

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
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 001997 CT Primary

Addresses

Primary practice location

61 Wells Rd
Wethersfield, CT 06109-3043

Mailing address

61 Wells Rd
Wethersfield, CT 06109-3043
Phone (860) 372-4811

Other identifiers 1

IdentifierTypeStateIssuer
008025895MedicaidCT

National Provider Directory

National Provider Directory
Tax ID family
CT Psychological Assessment Center LLC2 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.

Locations

61 Wells Rd
Wethersfield, CT 06109
Phone (860) 372-4811

Practitioners & affiliated clinicians

Practitioners 1

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": "1310601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310601600000",
    "number": "1548558232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WELLS RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093043",
            "telephone_number": "860-372-4811",
            "fax_number": "860-372-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WELLS RD",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061093043",
            "telephone_number": "860-372-4811",
            "fax_number": "860-372-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT PSYCHOLOGICAL & ASSESSMENT CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-14",
        "last_updated": "2011-07-14",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-904-3444",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "001997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008025895",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wethersfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2011; 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.