NPIMap

Organization Active NPI

Community Renewal Team, Inc

  • Community/Behavioral Health Agency
  • Hartford, CT
National Provider Identifier
1841569639
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
007823 Issued in CT
Legal business name
COMMUNITY RENEWAL TEAM, INC
Practice address
330 Market St
Hartford, CT 06120-2901
Phone
(860) 714-2010
Fax
(860) 714-8516
NPI assigned
Dec 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Authorized official

Name
Andrea M Quick, LCSW
Title
Clinician
Phone
(860) 714-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 007823 CT Primary

Addresses

Primary practice location

330 Market St
Hartford, CT 06120-2901

Mailing address

330 Market St
Hartford, CT 06120-2901
Phone (860) 714-2010

Other identifiers 1

IdentifierTypeStateIssuer
0077823OtherCTLCSW

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1841569639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MARKET ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061202901",
            "telephone_number": "860-714-2010",
            "fax_number": "860-714-8516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MARKET ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061202901",
            "telephone_number": "860-714-2010",
            "fax_number": "860-714-8516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RENEWAL TEAM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "QUICK",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "860-714-2010",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "007823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "0077823",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.