NPIMap

Organization Active NPI

Christian Counseling Center of Greater Danbury Inc

  • Counselor
  • Brookfield, CT
National Provider Identifier
1811068893
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
CHRISTIAN COUNSELING CENTER OF GREATER DANBURY INC
Practice address
2 Old New Milford Road
Landmark Office Building Suite 2a
Brookfield, CT 06804-2426
Phone
(203) 775-3282
Fax
(203) 775-3478
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Authorized official

Name
Mrs. Cheryl Ann Fusco, RN MHCNSNPI 1447356076
Title
Assistant Director
Phone
(203) 775-3282

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 006329 CT

Addresses

Primary practice location

2 Old New Milford Road
Landmark Office Building Suite 2a
Brookfield, CT 06804-2426

Mailing address

2 Old New Milford Road
Landmark Office Building Suite 2a
Brookfield, CT 06804-2426
Phone (203) 775-3282

Other identifiers 3

IdentifierTypeStateIssuer
008007955MedicaidCT
004258077MedicaidCT
008062840MedicaidCT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080115000377 CT Part B Supplier - Clinic/Group Practice 2264513365 Receives reassigned benefits from 6 practitioners
Practice locations: Brookfield, CT

National Provider Directory

National Provider Directory

Locations

2 Old New Milford Rd
Ste 2A
Brookfield, CT 06804
Phone (203) 775-3282

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1811068893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OLD NEW MILFORD ROAD",
            "address_2": "LANDMARK OFFICE BUILDING SUITE 2A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042426",
            "telephone_number": "203-775-3282",
            "fax_number": "203-775-3478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OLD NEW MILFORD ROAD",
            "address_2": "LANDMARK OFFICE BUILDING SUITE 2A",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042426",
            "telephone_number": "203-775-3282",
            "fax_number": "203-775-3478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COUNSELING CENTER OF GREATER DANBURY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "FUSCO",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR",
        "authorized_official_telephone_number": "203-775-3282",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN MHCNS"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "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": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "006329",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008007955",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004258077",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008062840",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.