Bayside Counseling, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001294 Issued in CT

Legal business name

BAYSIDE COUNSELING, LLC

Practice address

1921 Boston Post Rd
#207
Westbrook, CT 06498-2171

Phone

(860) 399-9500

Fax

(888) 232-7553

NPI assigned

Dec 16, 2008

Last updated

Jan 30, 2013By 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

Mrs. Dena Marie Otrin, LPC

Title

Owner/Member

Phone

(860) 399-9500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1700021029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1921 BOSTON POST RD STE 207",
            "address_2": "PO BOX 47",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064982171",
            "telephone_number": "860-399-9500",
            "fax_number": "888-232-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 BOSTON POST RD",
            "address_2": "#207",
            "city": "WESTBROOK",
            "state": "CT",
            "postal_code": "064982171",
            "telephone_number": "860-399-9500",
            "fax_number": "888-232-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "OTRIN",
        "authorized_official_first_name": "DENA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "860-399-9500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008013938",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Heidi Bridge

• Professional Counselor in Westbrook, CT
• Providers in Westbrook, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; 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.