NPIMap

Organization Active NPI

CT Mediation and Therapy, LLC

  • Community/Behavioral Health Agency
  • Manchester, CT
National Provider Identifier
1720492614
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
002174 Issued in CT
Legal business name
CT MEDIATION AND THERAPY, LLC
Practice address
357 E Center St
Manchester, CT 06040-4472
Phone
(860) 890-8689
NPI assigned
Jun 18, 2014
Last updated
Jun 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Authorized official

Name
Mr. Matthew Paul Bohonowicz, LPCNPI 1124206982
Title
Therapist-Mediator
Phone
(860) 890-8689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 002174 CT Primary

Addresses

Primary practice location

357 E Center St
Manchester, CT 06040-4472

Mailing address

357 E Center St
Manchester, CT 06040-4472
Phone (860) 890-8689

National Provider Directory

National Provider Directory

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": "1403049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1720492614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "357 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404472",
            "telephone_number": "860-890-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 E CENTER ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404472",
            "telephone_number": "860-890-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT MEDIATION AND THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "BOHONOWICZ",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "THERAPIST-MEDIATOR",
        "authorized_official_telephone_number": "860-890-8689",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "002174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.