NPIMap

Organization Active NPI

Connecticut Counseling Centers, Inc

  • Methadone Clinic
  • Meriden, CT
National Provider Identifier
1669047494
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
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
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 24

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20200225001773 CT Part B Supplier - Opioid Treatment Program (Otp) 0345677761 4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Danbury, CT; Meriden, CT; Norwalk, CT; Waterbury, CT

National Provider Directory

National Provider Directory
Tax ID family
Connecticut Counseling Centers Inc (25 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

NPPES NPI Registry

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

NPPES NPI Registry
IdentifierTypeStateIssuer
630OtherCTDEPARTMENT OF PUBLIC HEALTH

Other names 1

NPPES NPI Registry
  • Connecticut Counseling Centers, Inc. Doing business as

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address jbradway@ctcounseling.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 24, 2021.

{
    "created_epoch": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1669047494",
    "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": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "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": [
        {
            "organization_name": "Connecticut Counseling Centers, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.
  • 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.