Connecticut Renaissance, Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

0241 Issued in CT

Legal business name

CONNECTICUT RENAISSANCE, INC

Doing business as

CT Renaissance

Practice address

466 W Main St
Waterbury, CT 06702-1123

Phone

(203) 591-8010

Fax

(203) 591-8586

NPI assigned

Jan 16, 2007

Last updated

Jun 30, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawn Patston, LMFTNPI 1508137381

Title

Chief Operating Officer

Phone

(203) 336-5225

Specialties & licenses 1

Addresses

Other names 1

• CT Renaissance Doing business as

Tax ID family

Connecticut Renaissance Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

• Connecticut Renaissance, Inc

  dba CT Renaissance

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norwalk, CT
  • NPI 1265449359
  NPD tax ID
• Connecticut Renaissance, Inc

  • Substance Abuse Rehabilitation Facility
  • Waterbury, CT
  • NPI 1649321696
  NPD tax ID
• Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Norwalk, CT
  • NPI 1144510694
  NPD tax ID
• Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bridgeport, CT
  • NPI 1194069708
  NPD tax ID
• Connecticut Renaissance, Inc.

  dba CT Renaissance

  • Mental Health Counselor
  • Bridgeport, CT
  • NPI 1215188826
  NPD tax ID
• Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waterbury, CT
  • NPI 1700352721
  NPD tax ID
• Connecticut Renaissance, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bridgeport, CT
  • NPI 1720130362
  NPD tax ID

Locations

Practitioners 2

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.

• Dawn Patston, LMFT

  • Mental Health Counselor
  • Bridgeport, CT
  • NPI 1508137381
  Authorized official Same address or phone
• Doug Gruber, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Waterbury, CT
  • NPI 1992076780
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1598817140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WATERVIEW DR STE 202",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064844368",
            "telephone_number": "203-336-5225",
            "fax_number": "203-336-2851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021123",
            "telephone_number": "203-591-8010",
            "fax_number": "203-591-8586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT RENAISSANCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "PATSTON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "203-336-5225",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CT",
            "license": "0241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CT Renaissance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Substance Abuse Rehabilitation Facility in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Substance Abuse Rehabilitation Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.