Connecticut Counseling Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

CONNECTICUT COUNSELING CENTER LLC

Practice address

408 Highland Avenue
Building a Suite 1
Cheshire, CT 06410-1234

Phone

(203) 397-6010

NPI assigned

Dec 13, 2021

Last updated

Dec 13, 2021By 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

Amanda Kedzior

Title

Owner Operator

Phone

(203) 397-6010

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1649939117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGHLAND AVENUE",
            "address_2": "SUITE 1",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 HIGHLAND AVENUE",
            "address_2": "BUILDING A SUITE 1",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064101234",
            "telephone_number": "203-397-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "KEDZIOR",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "203-397-6010"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.