Organization Active NPI

The Neuro Health Clinic

Doing business as CT Neuro Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Rocky Hill, CT
National Provider Identifier
1669141297
Registry record updated Jan 30, 2023
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
THE NEURO HEALTH CLINIC
Practice address
West Elm Office Commons
1080 Elm St Suite 201
Rocky Hill, CT 06067-1847
Phone
(860) 208-6964
Fax
(860) 345-5928
NPI assigned
Sep 8, 2021
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Jacob Williams, LPC
Title
Clinical Director
Phone
(860) 208-6964

Specialties & licenses 1

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

Addresses

Primary practice location

West Elm Office Commons
1080 Elm St Suite 201
Rocky Hill, CT 06067-1847

Mailing address

West Elm Office Commons
1080 Elm St Suite 201
Rocky Hill, CT 06067
Phone (860) 208-6964

Other names 1

  • CT Neuro Health Former legal business name

National Provider Directory

National Provider Directory

Locations

1080 Elm St
Ste 201
Rocky Hill, CT 06067
Phone (860) 208-6964

175 Capital Blvd
Rocky Hill, CT 06067
Phone (203) 598-4864

Practitioners & affiliated clinicians

Practitioners 1

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": "1631059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1669141297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WEST ELM OFFICE COMMONS",
            "address_2": "1080 ELM ST SUITE 201",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "06067",
            "telephone_number": "860-208-6964",
            "fax_number": "860-345-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WEST ELM OFFICE COMMONS",
            "address_2": "1080 ELM ST SUITE 201",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060671847",
            "telephone_number": "860-208-6964",
            "fax_number": "860-345-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NEURO HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-08",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "860-208-6964",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CT Neuro Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CT Neuro Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CT Neuro Health",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Rocky Hill, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.