NPIMap

Organization Active NPI

State of Connecticut

Doing business as Western Connecticut Mental Health Network

  • Adult Mental Health Clinic/Center
  • Waterbury, CT
National Provider Identifier
1841225489
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
STATE OF CONNECTICUT
Doing business as
Western Connecticut Mental Health Network
Practice address
55 West Main Street
Suite 410 Rowland State Government Center
Waterbury, CT 06702
Phone
(203) 805-6403
Fax
(203) 805-6432
NPI assigned
Jul 12, 2006
Last updated
Oct 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Authorized official

Name
Ms. Cheryl Arora
Title
Chief Financial Officer
Phone
(860) 418-6937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

55 West Main Street
Suite 410 Rowland State Government Center
Waterbury, CT 06702

Mailing address

55 West Main Street
Suite 410 Rowland State Government Center
Waterbury, CT 06702
Phone (203) 805-6403

Other identifiers 2

IdentifierTypeStateIssuer
004120333MedicaidCT
004217106MedicaidCT

Other names 1

  • Western Connecticut Mental Health Network Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040319000427 CT Part B Supplier - Clinic/Group Practice 8022915677 Receives reassigned benefits from 104 practitioners
Practice locations: Waterbury, CT; Torrington, CT; Danbury, CT

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
John Dempsey Hosp74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1669 Thomaston Ave
Waterbury, CT 06704
Phone (203) 759-3505

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
John Dempsey HospitalFarmington, CT, CCN 070036 Hospital Operational/Managerial Control (100%) Jul 1, 1966
Albert J. Solnit Children's Center - South CampusMiddletown, CT, CCN 074015 Hospital Operational/Managerial Control (100%) Jun 1, 2011
Conneticut Valley HospitalHartford, CT, CCN 074003 Hospital Operational/Managerial Control Mar 30, 2015
Connecticut Mental Health CenterNew Haven, CT, CCN 074011 Hospital Operational/Managerial Control Mar 30, 2015
Southwest Connecticut Mental Health System (Swcmhs)Bridgeport, CT, CCN 074012 Hospital Operational/Managerial Control May 2, 1988
John L. Levitow Health Care CenterRocky Hill, CT, CCN 075443 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Mar 4, 2020
Jan 1, 2025

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 109

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 109

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1841225489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WEST MAIN STREET",
            "address_2": "SUITE 410 ROWLAND STATE GOVERNMENT CENTER",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06702",
            "telephone_number": "203-805-6403",
            "fax_number": "203-805-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WEST MAIN STREET",
            "address_2": "SUITE 410 ROWLAND STATE GOVERNMENT CENTER",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "06702",
            "telephone_number": "203-805-6403",
            "fax_number": "203-805-6432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "ARORA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "860-418-6937",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004120333",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004217106",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Connecticut Mental Health Network",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Western Connecticut Mental Health Network",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.