NPIMap

Organization Active NPI

Midwestern Connecticut Council on Alcoholism, Inc.

  • Community/Behavioral Health Agency
  • New Milford, CT
National Provider Identifier
1992074413
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
SA-0215 Issued in CT
Legal business name
MIDWESTERN CONNECTICUT COUNCIL ON ALCOHOLISM, INC.
Practice address
62 Bridge St
New Milford, CT 06776-3547
Phone
(860) 355-7312
Fax
(860) 354-7023
NPI assigned
Dec 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Mrs. Jaya Daptardar
Title
V.P of Behavioral Healthcare
Phone
(203) 792-4515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X SA-0215 CT Primary

Addresses

Primary practice location

62 Bridge St
New Milford, CT 06776-3547

Mailing address

38 Old Ridgebury Rd
Danbury, CT 06810-5128
Phone (203) 792-4515

Other identifiers 1

IdentifierTypeStateIssuer
008031626MedicaidCT

Other names 1

  • MCCA, inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
McCa Inc5 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.

Locations

38 Old Ridgebury Rd
Danbury, CT 06810
Phone (203) 792-4515

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1992074413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 OLD RIDGEBURY RD",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068105128",
            "telephone_number": "203-792-4515",
            "fax_number": "203-748-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 BRIDGE ST",
            "city": "NEW MILFORD",
            "state": "CT",
            "postal_code": "067763547",
            "telephone_number": "860-355-7312",
            "fax_number": "860-354-7023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWESTERN CONNECTICUT COUNCIL ON ALCOHOLISM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "DAPTARDAR",
        "authorized_official_first_name": "JAYA",
        "authorized_official_title_or_position": "V.P OF BEHAVIORAL HEALTHCARE",
        "authorized_official_telephone_number": "203-792-4515",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "SA-0215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008031626",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCCA, inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Milford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.