NPIMap

Organization Active NPI

First Light Collective Incorporated

  • Community/Behavioral Health Agency
  • Manchester, CT
National Provider Identifier
1609665520
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FIRST LIGHT COLLECTIVE INCORPORATED
Practice address
28 Kensington St
Manchester, CT 06040-5422
Phone
(860) 648-3592
NPI assigned
May 6, 2025
Last updated
Jun 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Authorized official

Name
Azaria Drakeford, LPC,LMHCNPI 1447723739
Title
Ceo
Phone
(860) 682-3358

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

28 Kensington St
Manchester, CT 06040-5422

Mailing address

28 Kensington St
Manchester, CT 06040-5422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20260209000585 MA Part B Supplier - Clinic/Group Practice 2668951823 Receives reassigned benefits from 1 practitioner
Practice locations: Springfield, MA
O20260331003275 CT Part B Supplier - Clinic/Group Practice 2668951823 Receives reassigned benefits from 1 practitioner
Practice locations: Manchester, CT

National Provider Directory

National Provider Directory

Locations

341 E Center St
#132
Manchester, CT 06040
Phone (860) 648-3592

99G Mill St
Springfield, MA 01108
Phone (413) 384-6132

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780444800000",
    "number": "1609665520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 KENSINGTON ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 KENSINGTON ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060405422",
            "telephone_number": "860-648-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST LIGHT COLLECTIVE INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-06",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A",
        "authorized_official_last_name": "DRAKEFORD",
        "authorized_official_first_name": "AZARIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-682-3358",
        "authorized_official_credential": "LPC,LMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.