NPIMap

Organization Active NPI

Connecticut Counseling Centers, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Meriden, CT
National Provider Identifier
1629643465
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CONNECTICUT COUNSELING CENTERS, INC.
Practice address
285 Kensington Ave
Meriden, CT 06451-2017
Phone
(203) 608-0205
Fax
(203) 608-0210
NPI assigned
May 24, 2021
Last updated
May 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Jason Bradway
Title
Director of Information Systems
Phone
(203) 568-7466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

285 Kensington Ave
Meriden, CT 06451-2017

Mailing address

50 Brookside Rd
Waterbury, CT 06708-1402
Phone (203) 568-7466

Other identifiers 1

IdentifierTypeStateIssuer
630OtherCTDEPARTMENT OF PUBLIC HEALTH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbradway@ctcounseling.org

National Provider Directory

National Provider Directory
Tax ID family
Connecticut Counseling Centers Inc25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1629643465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BROOKSIDE RD",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067081402",
            "telephone_number": "203-568-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 KENSINGTON AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064512017",
            "telephone_number": "203-608-0205",
            "fax_number": "203-608-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT COUNSELING CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "BRADWAY",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "DIRECTOR OF INFORMATION SYSTEMS",
        "authorized_official_telephone_number": "203-568-7466"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "630",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbradway@ctcounseling.org",
            "affiliation": "N",
            "address_1": "285 Kensington Ave",
            "city": "Meriden",
            "state": "CT",
            "country_code": "US",
            "postal_code": "064512017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meriden, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.