NPIMap

Organization Active NPI

Andover, Hebron, Marlborough Youth & Family Services, Inc.

  • Marriage & Family Therapist
  • Hebron, CT
National Provider Identifier
1801050398
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
ANDOVER, HEBRON, MARLBOROUGH YOUTH & FAMILY SERVICES, INC.
Practice address
25 Pendleton Dr
Hebron, CT 06248-1525
Phone
(860) 228-9488
Fax
(860) 228-1213
NPI assigned
Jul 14, 2008
Last updated
Jul 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Authorized official

Name
Mrs. Sarah Kate Ekvall
Title
Clinical Department
Phone
(860) 228-9488

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

25 Pendleton Dr
Hebron, CT 06248-1525

Mailing address

25 Pendleton Dr
Hebron, CT 06248-1525
Phone (860) 228-9488

National Provider Directory

National Provider Directory

Locations

25 Pendleton Dr
Hebron, CT 06248
Phone (860) 228-9488

Practitioners & affiliated clinicians

Practitioners 10

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": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1801050398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 PENDLETON DR",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481525",
            "telephone_number": "860-228-9488",
            "fax_number": "860-228-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PENDLETON DR",
            "city": "HEBRON",
            "state": "CT",
            "postal_code": "062481525",
            "telephone_number": "860-228-9488",
            "fax_number": "860-228-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDOVER, HEBRON, MARLBOROUGH YOUTH & FAMILY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "EKVALL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "KATE",
        "authorized_official_title_or_position": "CLINICAL DEPARTMENT",
        "authorized_official_telephone_number": "860-228-9488",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hebron, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.