NPIMap

Organization Active NPI

Adolescent & Family Counseling Center, LLC

  • Clinical Social Worker
  • Cheshire, CT
National Provider Identifier
1811906241
Registry record updated Jul 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
ADOLESCENT & FAMILY COUNSELING CENTER, LLC
Practice address
350 S Main St
The Republic Building / Suite 23
Cheshire, CT 06410-3160
Phone
(203) 271-1234
Fax
(203) 272-9094
NPI assigned
Aug 5, 2006
Last updated
Jul 7, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2008

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

Authorized official

Name
Mr. Herbert Jay Rosenfield, ACSW, LCSW, BCDNPI 1467403576
Title
Director
Phone
(203) 271-1234

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
Professional Counselor 101YP2500X CT
School Psychologist 103TS0200X CT
Clinical Social Worker 1041C0700X CT Primary
Marriage & Family Therapist 106H00000X CT

Addresses

Primary practice location

350 S Main St
The Republic Building / Suite 23
Cheshire, CT 06410-3160

Mailing address

350 S Main St
The Republic Building / Suite 23
Cheshire, CT 06410-3160
Phone (203) 271-1234

Other identifiers 6

IdentifierTypeStateIssuer
004257160MedicaidCT
248108OtherCTMANAGED HEALTH NETWORK
004257194MedicaidCT
004257201MedicaidCT
7348011OtherCTAETNA HEALTH MANAGEMENT
A391854OtherCTOXFORD HEALTH PLAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051007000412 CT Part B Supplier - Clinic/Group Practice 4486679560 Receives reassigned benefits from 4 practitioners
Practice locations: Danbury, CT; Cheshire, CT

National Provider Directory

National Provider Directory

Locations

350 S Main St
Ste 23
Cheshire, CT 06410
Phone (203) 271-1234

72 North St
Danbury, CT 06810
Phone (203) 748-1200

72 North St
Ste 205
Danbury, CT 06810
Phone (203) 790-1234

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215388800000",
    "number": "1811906241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S MAIN ST",
            "address_2": "THE REPUBLIC BUILDING / SUITE 23",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103160",
            "telephone_number": "203-271-1234",
            "fax_number": "203-272-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S MAIN ST",
            "address_2": "THE REPUBLIC BUILDING / SUITE 23",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103160",
            "telephone_number": "203-271-1234",
            "fax_number": "203-272-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADOLESCENT & FAMILY COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-07-07",
        "status": "A",
        "authorized_official_last_name": "ROSENFIELD",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "203-271-1234",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ACSW, LCSW, BCD"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "CT",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004257160",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "248108",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004257194",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004257201",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH MANAGEMENT",
            "identifier": "7348011",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "A391854",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; 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.