NPIMap

Organization Active NPI

The Christian Counseling and Family Life Center, Inc.

  • Marriage & Family Therapist
  • Shelton, CT
National Provider Identifier
1740313568
Registry record updated Jan 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
THE CHRISTIAN COUNSELING AND FAMILY LIFE CENTER, INC.
Practice address
25 Church St
Shelton, CT 06484
Phone
(203) 929-1117
Fax
(203) 925-9645
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2015

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

Authorized official

Name
Marcella Rende, LMFTNPI 1639261217
Title
Admin. Director
Phone
(203) 929-1117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X CT
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X CT Primary

Addresses

Primary practice location

25 Church St
Shelton, CT 06484

Mailing address

25 Church St.
Shelton, CT 06484
Phone (203) 929-1117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041108000233 CT Part B Supplier - Clinic/Group Practice 4688637010 Receives reassigned benefits from 11 practitioners
Practice locations: Shelton, CT

National Provider Directory

National Provider Directory

Locations

25 Church St
Shelton, CT 06484
Phone (203) 929-1117

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1740313568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 CHURCH ST.",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "06484",
            "telephone_number": "203-929-1117",
            "fax_number": "203-925-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CHURCH ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "06484",
            "telephone_number": "203-929-1117",
            "fax_number": "203-925-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHRISTIAN COUNSELING AND FAMILY LIFE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "RENDE",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_title_or_position": "ADMIN. DIRECTOR",
        "authorized_official_telephone_number": "203-929-1117",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; 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.