CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.


Address: 75 Granite St, New London, CT 06320-5730
Phone: 8604374550

CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC. (NPI# 1093762114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1093762114
Entity Type Organization
Organization Name CHILD AND FAMILY AGENCY OF SOUTHEASTERN CONNECTICUT, INC.
Practice Address 75 Granite St
New London
CT 06320-5730
Mailing Address 255 Hempstead St
New London
CT 06320-6204
Practice Telephone 8604374550
Practice Fax Number 8604374552
Mailing Telephone 8604432896
Mailing Fax Number 8604425909
Enumeration Date 2006-05-27
Last Update Date 2019-06-20
Authorized Official Name LISA BAXTER (CHIEF FINANCIAL AND ADMIN OFFICER)
Authorized Official Telephone 8604432896
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CT 004083309 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
190 Westbrook Rd, Essex, CT 064261518 8607670147 8607670148
591 Poquonnock Rd, Groton, CT 063404571 8604498217 8604498323

Other Provider IDs and Locations

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
1053652651 Child and Family Agency of Southeastern Connecticut, Inc. Clinic/Center 40 Field St, Pawcatuck, CT 06379-2186 2013-03-06
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

Other Data Sources

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

Office Location

Street Address 75 GRANITE ST
City NEW LONDON
State CT
Zip Code 06320-5730

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104433580 Rachel K Daley Social Worker 75 Granite St, New London, CT 06320-5730 2020-09-29
1295341444 Allison Monica Beeley Marriage & Family Therapist 75 Granite St, New London, CT 06320-5730 2020-09-22
1659984193 Alexis Spinnato Social Worker 75 Granite St, New London, CT 06320-5730 2020-08-25
1841834173 Silvia Cooke-salinas Social Worker 75 Granite St, New London, CT 06320-5730 2019-10-30
1932742426 Alexandra Jaye Garvey Social Worker 75 Granite St, New London, CT 06320-5730 2019-10-28
1629629704 Mariel Ozoria Counselor 75 Granite St, New London, CT 06320-5730 2019-09-20
1295387843 Sara Diane Lambert Nurse Practitioner 75 Granite St, New London, CT 06320-5730 2019-07-14
1811557085 James Robertson Marriage & Family Therapist 75 Granite St, New London, CT 06320-5730 2019-06-19
1598322356 Victoria Daniw Counselor 75 Granite St, New London, CT 06320-5730 2019-05-28
1619475001 Jessica Boucher Social Worker 75 Granite St, New London, CT 06320-5730 2018-01-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1942824891 Shilpi Jain Physical Therapist 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 2020-06-05
1174009641 Catherine Hinojosa Nurse Practitioner 1 Shaws Cove, New London, CT 06320 2018-07-17
1043668320 Cultivate & Grow Inc. Counselor 302 State St Suite 307, New London, CT 06320 2016-05-27
1295137263 Jacqueline Durnell Registered Nurse 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 2014-09-22
1922427541 Corina Vendetto Registered Nurse 245 Shaw St., New London, CT 06320 2014-04-10
1912329962 Janelle Posey-green Social Worker 302 State St., Suite 201, New London, CT 06320 2014-01-10
1750622692 Cynthia Mitchell Social Worker 65b Michael Rd, New London, CT 06320 2013-03-01
1518254507 Simon J Shapiro Physical Medicine & Rehabilitation 190 Howard Avenue, New London, CT 06320 2011-06-29
1184876708 Jane P Genido-trujillo Nurse Practitioner 270 Mohegan Ave., Student Health Services, New London, CT 06320 2008-10-14
1932356284 Gerard Joseph Ventura Dentist 21 Montauk Ave., Suite 102, New London, CT 06320 2008-08-19
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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1396700886 Sound Community Services, Inc. Clinic/Center 21 Montauk Avenue, New London, CT 06320-4906 2006-04-19
1215393327 Child and Family Agency of Southeastern Connecticut, Inc. Clinic/Center 7 Vauxhall St, New London, CT 06320-5711 2016-01-05
1679614242 Child and Family Agency of Southeastern Connecticut, Inc. Clinic/Center 75 Granite St, New London, CT 06320-5730 2007-02-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1548867823 Marianne Cardillo LLC Clinic/Center 72 Cedar Heights Rd, Stamford, CT 06905-1105 2020-10-08
1770180770 Thriving Minds Connecticut, LLC Clinic/Center 39 Leonard Rd, Middlebury, CT 06762-3602 2020-10-03
1093326464 Hope Haven, LLC Clinic/Center 543 Kanuga Trl, Orange, CT 06477-2659 2020-08-11
1760093108 Intuitive Healing Counseling LLC Clinic/Center 95 Armory Rd Ste 2, Stratford, CT 06614-1753 2020-08-10
1750992244 Connecting The Pieces, LLC Clinic/Center 151 New Park Ave Unit 27, Hartford, CT 06106-2181 2020-08-10
1063021228 Clear Sky Therapy Services Clinic/Center 68 Lyman Rd, West Hartford, CT 06117-1311 2020-07-23
1104453562 Empower Therapy & Wellness LLC Clinic/Center 786 Boston Post Rd # 203, Madison, CT 06443-3036 2020-03-25
1386279453 Pathways To Wellness, LLC Clinic/Center 74 Sheldon Ter, New Haven, CT 06511-2006 2020-03-09
1053945196 Farley Counseling Services Clinic/Center 29b Hartford Ave, Granby, CT 06035-2326 2020-02-27
1922630557 Starfish Family Connections, LLC Clinic/Center 1367 Hanover Ave Apt 602, Meriden, CT 06451-6278 2020-02-11
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Competitor

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City NEW LONDON
Zip Code 06320

Improve Information

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Dataset Information

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.

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