SOUTHERN CT CHRISTIAN NETWORK (NPI# 1033239249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033239249 |
| Entity Type | Organization |
| Organization Name | SOUTHERN CT CHRISTIAN NETWORK |
| Other Organization Name | SHORELINE CHRISTIAN COUNSELING |
| Practice Address |
145 Durham Rd Mailbox 7 Madison CT 06443-2674 |
| Practice Telephone | 2033180070 |
| Practice Fax Number | 2063398205 |
| Mailing Telephone | 2033180070 |
| Mailing Fax Number | 2063398205 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2008-10-14 |
| Authorized Official Name | MRS. ULARI DIKE (OFFICE MANAGER) |
| Authorized Official Telephone | 2033180700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
001460 | CT | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
002876 | CT | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
004809 | CT | Behavioral Health & Social Service Providers |
| Y | 2084F0202X |
Psychiatry & Neurology Specialization: Forensic Psychiatry |
039301 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004257277 | 05 | |
| CT | HEALTHNET-MHN | 307875 | 01 |
| CT | 004257269 | 05 | |
| CT | 004257532 | 05 |
| Other Name | Type Code |
|---|---|
| Shoreline Christian Counseling | Doing Business As Name - Organization |
| Street Address |
145 DURHAM RD MAILBOX 7 |
| City | MADISON |
| State | CT |
| Zip Code | 06443-2674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598763997 | Paul J Coppola | Obstetrics & Gynecology | 145 Durham Rd, Suite 1, Madison, CT 06443-2674 | 2005-07-09 |
| 1720553217 | Kaitlyn Defelice | Behavioral Analyst | 145 Durham Rd, Madison, CT 06443-2674 | 2018-10-10 |
| 1932652310 | Caitlin Bracale | Occupational Therapist | 145 Durham Rd, Madison, CT 06443-2674 | 2016-08-02 |
| 1902264674 | Jessica Robison | Speech-Language Pathologist | 145 Durham Rd, Suite 9, Madison, CT 06443-2674 | 2016-02-09 |
| 1942631023 | Stephanie Gilfoy | Naturopath | 145 Durham Rd, Suite 1, Madison, CT 06443-2674 | 2013-11-27 |
| 1790058170 | Shari A. Roguski Dc, LLC | Chiropractor | 145 Durham Rd, Suite 6, Madison, CT 06443 | 2012-02-16 |
| 1568790376 | Dk Consultants LLC | Psychiatry & Neurology | 145 Durham Rd, Box 7 Suite 10, Madison, CT 06443-2674 | 2009-12-07 |
| 1205086287 | David J. Golden, Dpm, LLC | Podiatrist | 145 Durham Rd, Madison, CT 06443-2674 | 2008-09-25 |
| 1689714412 | Terese M Naser | Chiropractor | 145 Durham Rd, Madison, CT 06443-2674 | 2007-02-08 |
| 1154415438 | Katherine E Black-lee | Podiatrist | 145 Durham Rd, Madison, CT 06443-2674 | 2006-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194127506 | Heather R. Clinton | Social Worker | 847 West Main Street, Suite 3, Branford, CT 06443 | 2014-09-17 |
| 1477973378 | Katrina Louise Furey | Psychiatry & Neurology | 147 Durham Rd Ste 12a-ne, Madison, CT 06443 | 2014-04-18 |
| 1972920114 | Elizabeth Laberee | Internal Medicine | 80 Devonshire Lane, Madison, CT 06443 | 2014-03-26 |
| 1588007314 | Avery Grauer | Psychiatry & Neurology | 175 Copse Road, Madison, CT 06443 | 2013-04-11 |
| 1295077790 | Gordon Seth Cohen | Pathology | 3 Silo Hill Road, Madison, CT 06443 | 2013-03-22 |
| 1073750493 | Darlene F. Talavera | Occupational Therapist | 22 Overshore Drive, Madison, CT 06443 | 2009-01-08 |
| 1013182518 | Susan Jean Isaac | Social Worker | 105 Winding Road, Unit 2, Madison, CT 06443 | 2008-04-25 |
| 1083893606 | Kornelia Keszler, Md, PC | Internal Medicine | 1-b Meigswood Ave, Madison, CT 06443 | 2007-10-31 |
| 1811181126 | Traci Marando | Nurse Practitioner | 20 Madrina Lane, Madison, CT 06443 | 2007-08-29 |
| 1790803419 | Linda L. Young | Social Worker | 2 Samson Rock Drive, Unit 2g, Madison, CT 06443 | 2007-03-27 |
| Find all providers in zip 06443 | ||||
| Taxonomy Code | 2084F0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Forensic Psychiatry |
| Forensic Psychiatry is a subspecialty with psychiatric focus on interrelationships with civil, criminal and administrative law, evaluation and specialized treatment of individuals involved with the legal system, incarcerated in jails, prisons, and forensic psychiatry hospitals. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518022748 | Kathleen Ann Hughes | Psychiatry & Neurology | 1265 John Q Hammons Drive, Madison, WI 53717-5500 | 2006-12-27 |
| 1356478887 | Brad E. R. Smith | Psychiatry & Neurology | 301 Troy Dr, Madison, WI 53704-1521 | 2007-02-28 |
| 1972647527 | Kevin Patrick Kallas | Psychiatry & Neurology | 3099 E Washington Ave, Madison, WI 53704-4338 | 2007-02-16 |
| 1548271844 | Jerrold Andrew Adkins | Psychiatry & Neurology | 6001 Research Park Blvd, Psychiatry Department, Madison, WI 53719 | 2006-08-11 |
| 1730106311 | Gary J Maier | Psychiatry & Neurology | 301 Troy Dr, Madison, WI 53704-1521 | 2006-07-17 |
| 1720022700 | Erik David Knudson | Psychiatry & Neurology | 301 Troy Dr, Madison, WI 53704-1521 | 2006-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841746369 | Mohit Singh | Psychiatry & Neurology | 360 State St., 1115, New Haven, CT 06510 | 2016-08-26 |
| 1841533551 | Donald Ross Grayson | Psychiatry & Neurology | 195 Farmington Avenue, Suite 203, Farmington, CT 06032 | 2013-04-01 |
| 1619113446 | Haleh Ghanizadeh | Psychiatry & Neurology | 83 West Ln, Ridgefield, CT 06877-4905 | 2008-12-29 |
| 1801052386 | Taiye Akinwande Ogundipe | Psychiatry & Neurology | 1 Turkey Hill Rd S Ste 100, Westport, CT 06880-5525 | 2008-08-04 |
| 1275613820 | Patrick Kevin Fox | Psychiatry & Neurology | Connecticut Valley Hospital, Russell Hall, Silver Street, Middletown, CT 06457 | 2006-10-17 |
| 1417929068 | Brenda L Planck | Psychiatry & Neurology | O'brien Drive, Middletown, CT 06457 | 2006-02-07 |
| 1467862706 | Elizabeth M Burch | Psychiatry & Neurology | 200 Retreat Avenue, Hartford Hospital Psychiatry Dept, Hartford, CT 06106-3309 | 2014-05-07 |
| 1962758698 | Rafik Sidaros | Psychiatry & Neurology | 34 Park St, New Haven, CT 06519-1109 | 2012-07-31 |
| 1851659015 | Naomi Lian | Psychiatry & Neurology | 184 Liberty St, New Haven, CT 06519-1625 | 2012-04-25 |
| 1609155308 | Karen H Brody, Md, LLC | Psychiatry & Neurology | 22 5th St, Stamford, CT 06905-5030 | 2011-08-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.