Active NPI
WBC Connecticut East, LLC
- Adult Mental Health Clinic/Center
- South Windsor, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Mental Health Clinic/Center
- Legal business name
- WBC CONNECTICUT EAST, LLC
- Practice address
- 2400 Tamarack Ave
Suite 203
South Windsor, CT 06074-5555 - Phone
- (860) 533-4672
- Fax
- (860) 533-4673
- NPI assigned
- Jun 20, 2012
- Last updated
- Oct 4, 2012
- Organization subpart
- Yes
- Parent organization
- WALDEN BEHAVIORAL CARE, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Stuart Koman, PHD
- Title
- Ceo / Owner
- Phone
- (781) 647-6701
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | Primary | ||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X |
Addresses
Primary practice location
2400 Tamarack Ave
Suite 203
South Windsor, CT 06074-5555
Mailing address
880 Main St
Waltham, MA 02451-8500
Phone (781) 647-6767
National Provider Directory
National Provider Directory- Part of
- Walden Behavioral Care LLC
Locations
880 Main St
Waltham, MA 02451
Phone (781) 647-6766
880 Main St
Fl 2
Waltham, MA 02451
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.
-
- Psychologist
- Waltham, MA
- NPI 1700172731
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1349308800000",
"number": "1730442179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "880 MAIN ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024518500",
"telephone_number": "781-647-6767",
"fax_number": "781-647-6755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2400 TAMARACK AVE",
"address_2": "SUITE 203",
"city": "SOUTH WINDSOR",
"state": "CT",
"postal_code": "060745555",
"telephone_number": "860-533-4672",
"fax_number": "860-533-4673"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WBC CONNECTICUT EAST, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WALDEN BEHAVIORAL CARE, LLC",
"enumeration_date": "2012-06-20",
"last_updated": "2012-10-04",
"status": "A",
"authorized_official_last_name": "KOMAN",
"authorized_official_first_name": "STUART",
"authorized_official_title_or_position": "CEO / OWNER",
"authorized_official_telephone_number": "781-647-6701",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Windsor, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.