The Latin Enrichment Organization LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

85 Issued in CT

Legal business name

THE LATIN ENRICHMENT ORGANIZATION LLC

Practice address

54 Forest St
Hartford, CT 06105-3204

Phone

(860) 249-0975

Fax

(860) 249-0975

NPI assigned

Feb 24, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Carlos Marrero, ACSW, MSW, EDD

Title

Executive Director

Phone

(860) 249-0975

Specialties & licenses 8

Addresses

Other names 4

• L.E.O. Clinic Doing business as
• LEO Behavioral Health Doing business as
• LEO Clinic Doing business as
• LEO Primary Care Other name

Tax ID family

The Latin Enrichment Organization LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Latin Enrichment Organization LLC

  • Primary Care Clinic/Center
  • Hartford, CT
  • NPI 1356939656
  NPD tax ID
• The Latin Enrichment Organization

  • Family Medicine Physician
  • Hartford, CT
  • NPI 1982290714
  NPD tax ID
• The Latin Enrichment Organization LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Hartford, CT
  • NPI 1144101445
  NPD tax ID
• The Latin Enrichment Organization LLC

  • Clinic/Center
  • Hartford, CT
  • NPI 1689555989
  NPD tax ID

Locations

Practitioners 1

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

• Lydia R. Roldan, NP

  • Adult Health Nurse Practitioner
  • Hartford, CT
  • NPI 1548280175
  NPD (past)

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1902298193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 380322",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061380322",
            "telephone_number": "860-249-0975",
            "fax_number": "860-249-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 FOREST ST",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061053204",
            "telephone_number": "860-249-0975",
            "fax_number": "860-249-0975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Main Street",
            "address_purpose": "LOCATION",
            "city": "East Hartford",
            "state": "CT",
            "postal_code": "06108",
            "country_code": "US",
            "telephone_number": "860-249-0975 x2",
            "fax_number": "860-249-0975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE LATIN ENRICHMENT ORGANIZATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "MARRERO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "860-249-0975",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ACSW, MSW, EDD"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "85",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "L.E.O. Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LEO Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LEO Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LEO Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LEO Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Hartford, CT
• Providers in Hartford, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.