NPIMap

Organization Active NPI

Change Talk LLC

  • Counselor
  • Essex, CT
National Provider Identifier
1780122713
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
CHANGE TALK LLC
Practice address
251 Essex Plaza
Essex, CT 06426
Phone
(860) 638-9169
Fax
(860) 469-2938
NPI assigned
Feb 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Adam Joseph Russo, MSNPI 1104281369
Title
Owner/Clinician
Phone
(860) 638-9169

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 003050 CT
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

251 Essex Plaza
Essex, CT 06426

Mailing address

251 Essex Plaza
Essex, CT 06426
Phone (860) 638-9169

Other identifiers 1

IdentifierTypeStateIssuer
008071044MedicaidCT

National Provider Directory

National Provider Directory

Locations

251 Essex Plz
Essex, CT 06426
Phone (860) 638-9169

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1780122713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 ESSEX PLAZA",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "06426",
            "telephone_number": "860-638-9169",
            "fax_number": "860-469-2938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 ESSEX PLAZA",
            "city": "ESSEX",
            "state": "CT",
            "postal_code": "06426",
            "telephone_number": "860-638-9169",
            "fax_number": "860-469-2938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE TALK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-10",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "860-638-9169",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CT",
            "license": "003050",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008071044",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.