NPIMap

Organization Active NPI

Catholic Charities,Diocese of Norwich, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Norwich, CT
National Provider Identifier
1649335688
Registry record updated Oct 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CATHOLIC CHARITIES,DIOCESE OF NORWICH, INC.
Practice address
331 Main St
Norwich, CT 06360
Phone
(860) 889-8346
Fax
(860) 889-2658
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2009

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

Authorized official

Name
Marek K Kukulka, LMFT
Title
Executive Director
Phone
(860) 889-8346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

331 Main St
Norwich, CT 06360

Mailing address

331 Main St
Norwich, CT 06360
Phone (860) 889-8346

Other identifiers 1

IdentifierTypeStateIssuer
00404689MedicaidCT

National Provider Directory

National Provider Directory

Locations

151 Broad St
Middletown, CT 06457
Phone (860) 342-0760

28 Huntington St
New London, CT 06320
Phone (860) 443-5328

22 Masonic St
New London, CT 06320
Phone (860) 443-5328

Practitioners & affiliated clinicians

Practitioners 12

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": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254873600000",
    "number": "1649335688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 MAIN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-889-8346",
            "fax_number": "860-889-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 MAIN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "06360",
            "telephone_number": "860-889-8346",
            "fax_number": "860-889-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC CHARITIES,DIOCESE OF NORWICH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2009-10-07",
        "status": "A",
        "authorized_official_last_name": "KUKULKA",
        "authorized_official_first_name": "MAREK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-889-8346",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00404689",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; 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.