CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC. (NPI# 1053652651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053652651 |
| Entity Type | Organization |
| Organization Name | CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC. |
| Practice Address |
40 Field St Pawcatuck CT 06379-2186 |
| Mailing Address |
255 Hempstead St New London CT 06320-6204 |
| Practice Telephone | 8605991603 |
| Practice Fax Number | 8605991604 |
| Mailing Telephone | 8604432896 |
| Mailing Fax Number | 8604425909 |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2019-06-20 |
| Authorized Official Name | LISA BAXTER (CHIEF FINANCIAL AND ADMIN OFFICER) |
| Authorized Official Telephone | 8604432896 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 0685 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008043737 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609414176 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 154 Toll Gate Rd, Groton, CT 06340-3444 | 2019-12-16 |
| 1962750539 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 160 Fishtown Rd, Mystic, CT 06355-2012 | 2012-08-29 |
| 1881871168 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 500 Poquonnock Rd, Groton, CT 06340-4568 | 2008-01-29 |
| 1043403942 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 40 Shaw St, New London, CT 06320-4922 | 2007-08-23 |
| 1467468025 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 101 Groton Long Point Rd, Groton, CT 06340-4861 | 2006-08-01 |
| 1013921048 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 37 Beech Dr, New London, CT 06320-3003 | 2006-07-27 |
| 1881608834 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 74 Grove St, New London, CT 06320-6515 | 2006-07-27 |
| 1669496048 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 1 Bulkeley Pl, New London, CT 06320-6206 | 2006-07-27 |
| 1467476853 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 7 Vauxhall St, New London, CT 06320-5711 | 2006-07-27 |
| 1548284946 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 250 Brandegee Ave, Groton, CT 06340-5108 | 2006-07-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC. | 255 Hempstead St, New London, CT 06320-6204 |
| Street Address |
40 FIELD ST |
| City | PAWCATUCK |
| State | CT |
| Zip Code | 06379-2186 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366957565 | Stacy Jean Wheland | Behavioral Analyst | 2 Hickory Ln, Pawcatuck, CT 06379 | 2017-12-11 |
| 1255882379 | Jacqueline M. Nichols-holden | Massage Therapist | 10 Croft Ct, Pawcatuck, CT 06379 | 2016-10-24 |
| 1972635027 | Roy C Gumpel | Internal Medicine | 86 Palmer Neck Rd, Pawcatuck, CT 06379 | 2007-03-12 |
| 1811062904 | Gene S Renz | Dentist | 101 West Broad Street, Pawcatuck, CT 06379 | 2006-11-22 |
| 1790746295 | Mary Sue Agostini | Physical Therapist | 158 South Broad Street, Dynamic Physical Therapy LLC, Pawcatuck, CT 06379 | 2006-04-01 |
| 1558907154 | Holden Hands Massage, LLC | Massage Therapist | 10 Croft Ct, Pawcatuck, CT 06379-1233 | 2019-11-19 |
| 1386178093 | Janine Brooks | Nurse Practitioner | 47 Elmridge Rd, Pawcatuck, CT 06379-1234 | 2017-04-19 |
| 1093369852 | Ryan David Lee | Specialist/Technologist | 1 Fairway Ct, Pawcatuck, CT 06379-1240 | 2019-07-30 |
| 1891094116 | Susan Alfiero-bavasso | Speech-Language Pathologist | 2 Fairway Ct, Pawcatuck, CT 06379-1240 | 2011-03-25 |
| 1164935250 | Katharine Headley | Student in an Organized Health Care Education/Training Program | 61 Timber Ridge Rd, Pawcatuck, CT 06379-1241 | 2017-11-10 |
| Find all providers in zip 06379 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265039093 | Thrive Haven LLC | Clinic/Center | 195 James St Fl 1, New Haven, CT 06513-3847 | 2020-10-05 |
| 1083229165 | Kusher Functional Medicine Center PC | Clinic/Center | 76 Eastern Blvd Ste 103, Glastonbury, CT 06033-4382 | 2020-09-15 |
| 1609414176 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 154 Toll Gate Rd, Groton, CT 06340-3444 | 2019-12-16 |
| 1811532500 | Alpha Wave Health Centers LLC | Clinic/Center | 10 Waterside Dr Ste 101, Farmington, CT 06032-3056 | 2019-11-17 |
| 1093282360 | Tms Neurohealth Pllc | Clinic/Center | 728 Post Rd E Ste 202, Westport, CT 06880-5200 | 2018-10-25 |
| 1982179784 | Wellness Primary Care Pllc | Clinic/Center | 291 S Lambert Rd Ste 5, Orange, CT 06477-3559 | 2018-10-08 |
| 1366953705 | Connecticut Neurodiagnostics, LLC | Clinic/Center | 83 Wooster Heights Rd., Suite 125, Office 145, Danbury, CT 06810 | 2017-10-12 |
| 1366993214 | Ascension Naturopathic Healing Center LLC | Clinic/Center | 175 Boston Post Road, Floor 1, Waterford, CT 06385 | 2016-10-16 |
| 1235588625 | Family Centers Inc. | Clinic/Center | 1 Wilbur Peck Ct Lowr Level, Greenwich, CT 06830-6354 | 2016-06-07 |
| 1578926424 | Chiropractic Wellness Center | Clinic/Center | 75 Hazard Ave Unit I, Enfield, CT 06082-3887 | 2016-03-29 |
| Find all providers with the same taxonomy | ||||
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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.