NPIMap

Organization Active NPI

State of Connecticut

Doing business as Connecticut Mental Health Center

  • Psychiatric Hospital
  • New Haven, CT
National Provider Identifier
1881629434
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
STATE OF CONNECTICUT
Doing business as
Connecticut Mental Health Center
Practice address
34 Park Street
New Haven, CT 06790
Phone
(203) 974-7417
Fax
(203) 974-7413
NPI assigned
Jul 12, 2006
Last updated
Sep 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 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
Psychiatric Hospital 283Q00000X NU Primary

Addresses

Primary practice location

34 Park Street
New Haven, CT 06790

Mailing address

34 Park Street
New Haven, CT 06790
Phone (203) 974-7417

Other identifiers 5

IdentifierTypeStateIssuer
004122933MedicaidCT
004064200MedicaidCT
004120143MedicaidCT
004025359MedicaidCT
004064218MedicaidCT

Other names 1

  • Connecticut Mental Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041227000221 CT Part B Supplier - Clinic/Group Practice 8022915677 Receives reassigned benefits from 125 practitioners
1 other NPI on this enrollment
Practice locations: New Haven, CT; West Haven, CT
O20100927000142 CT Part A Provider - Hospital 8022915677 Practice locations: New Haven, CT; West Haven, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881629434. Details of each certification follow.

Hospital certification: CCN 074011

Legal name
STATE OF CONNECTICUT
Doing business as
CONNECTICUT MENTAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Nov 4, 1982
Last certification
Apr 13, 2011
Beds
70
Ownership / control type
State
Organization structure
OtherNon-profit
Enrollment address
34 Park St
New Haven, CT 65191109
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Connecticut Mental Health CenterCCN 074011 · All quality measures
Type
Psychiatric
Ownership
Government - State
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Locations

165 Capitol Ave
Ste 2000
Hartford, CT 06106

410 Capitol Ave
Hartford, CT 06106
Phone (203) 805-5300

34 Park St
Ofc 142
New Haven, CT 06519

34 Park St
North Haven, CT 06519
Phone (203) 974-7417

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christina Arias Individual Corporate DirectorDirector of Healthcare Finance Jan 1, 2022
W-2 Managing EmployeeDirector of Healthcare Finance Jan 1, 2022
State of Connecticut Organization, Hartford, CT Operational/Managerial Control Mar 30, 2015

Owners & managing parties with NPI records 10

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 5

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
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 6

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

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 245

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 245

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": "1664236800000",
    "number": "1881629434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PARK STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "203-974-7417",
            "fax_number": "203-974-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PARK STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "203-974-7417",
            "fax_number": "203-974-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF CONNECTICUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "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": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004122933",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004064200",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004120143",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004025359",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004064218",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connecticut Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Connecticut Mental Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.