CONNECTICUT RENAISSANCE, INC. (NPI# 1215188826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215188826 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT RENAISSANCE, INC. |
| Practice Address |
115 Middle St Bridgeport CT 06604-4410 |
| Mailing Address |
350 Fairfield Ave Suite 701 Bridgeport CT 06604-6014 |
| Practice Telephone | 2033369755 |
| Mailing Telephone | 2033365225 |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2008-10-02 |
| Authorized Official Name | MR. JOSEPH RIKER (CEO/CFO) |
| Authorized Official Telephone | 2033365225 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
PENDING | CT | Behavioral Health & Social Service Providers |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
PENDING | CT | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194069708 | Connecticut Renaissance, Inc. | Clinic/Center | 1126 Main St, Bridgeport, CT 06604-4404 | 2012-11-20 |
| 1700893807 | Connecticut Renaissance, Inc. | Clinic/Center | 141 Franklin St, Stamford, CT 06901-1014 | 2006-08-02 |
| 1700352721 | Connecticut Renaissance, Inc. | Clinic/Center | 527 Wolcott St, Waterbury, CT 06705-1240 | 2018-10-17 |
| 1144510694 | Connecticut Renaissance, Inc. | Clinic/Center | 17 High St, Norwalk, CT 06851-4723 | 2011-04-18 |
| 1669617973 | Connecticut Renaissance, Inc. | Clinic/Center | 70 Central Ave, Waterbury, CT 06702-1207 | 2008-12-16 |
| 1720130362 | Connecticut Renaissance, Inc. | Clinic/Center | 1 Lafayette Cir, Bridgeport, CT 06604-6021 | 2007-01-16 |
| 1740297845 | Connecticut Renaissance, Inc. | Clinic/Center | 1120 Main St, Bridgeport, CT 06604-4404 | 2006-08-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CONNECTICUT RENAISSANCE, INC | 1 Waterview Dr Ste 202, Shelton, CT 06484-4368 |
| Connecticut Business Registrations | CONNECTICUT RENAISSANCE, INC. | 350 Fairfield Ave., Ste. 701, Bridgeport, CT 06604 |
| Street Address |
115 MIDDLE ST |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06604-4410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063629020 | Leah Cefaloni | Counselor | 115 Middle St, Bridgeport, CT 06604-4416 | 2007-05-17 |
| 1922342518 | Amanda L Young | Counselor | 115 Middle St, Bridgeport, CT 06604-4416 | 2012-11-20 |
| 1275804056 | Laura Shipman | Counselor | 115 Middle St, Bridgeport, CT 06604-4416 | 2012-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780163246 | Jill K Bebey | Pharmacist | 564 A Park Ave, Bridgeport, CT 06604 | 2018-08-07 |
| 1538663430 | Ryan Attar | Naturopath | 129 Columbia St, Bridgeport, CT 06604 | 2018-03-23 |
| 1487153375 | Fe Y Esperanza Home Care Services | Home Health | 2032 Main Street, Bridgeport, CT 06604 | 2018-02-06 |
| 1013423466 | Va.lu Able Home Care LLC | Registered Nurse | 1000 Lafayette Boulvard, Bridgeport, CT 06604 | 2017-12-21 |
| 1679970172 | Aarti Jawa | Dentist | 594 Pequonnoack Street, Bridgeport, CT 06604 | 2014-11-26 |
| 1932521473 | Anthony Santostefano | Dentist | 594 Pequonnock Street, Bridgeport, CT 06604 | 2014-01-18 |
| 1699011536 | Vanessa Frances Doyle | Naturopath | 115 Broad Street, C/o Center of Excellence, Bridgeport, CT 06604 | 2012-12-21 |
| 1942463302 | Joanna Conte Mcgary | Naturopath | 60 Lafayette Street, Naturopathic Medical Center University of Bridgeport, Bridgeport, CT 06604 | 2008-07-07 |
| 1346415221 | Jenna Lyn Blasi | Naturopath | 60 Lafayette, University of Bridgeport College of Naturopathic Medici, Bridgeport, CT 06604 | 2008-04-23 |
| 1275704462 | Watermark 3030 Park LLC | Skilled Nursing Facility | 3030 Park Ave, Bridgeport, CT 06604 | 2008-03-17 |
| Find all providers in zip 06604 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528666955 | Emily Mariah Wolf | Counselor | 1154 Walnut Grove Rd, Bridgeport, NY 13030-9760 | 2020-10-16 |
| 1437760071 | Danielle Gofman | Counselor | 2675 Park Ave Unit 29, Bridgeport, CT 06604-1356 | 2020-08-16 |
| 1134691868 | Margaret Katherine Leska | Counselor | 180 Fairfield Ave # 1, Bridgeport, CT 06604-4252 | 2018-12-19 |
| 1124595772 | Julia Frank | Counselor | 4699 Main St Ste 105, Bridgeport, CT 06606-1830 | 2018-10-31 |
| 1801267265 | Zachary Grill | Counselor | 123 Gilman St, Bridgeport, CT 06605-3314 | 2015-10-12 |
| 1992185102 | Juliet Jacob | Counselor | 3250 Fairfield Ave Apt 317, Bridgeport, CT 06605-3273 | 2015-06-02 |
| 1477958080 | Luis Alejandro Castellon Jr. | Counselor | 121 Frank St, Bridgeport, CT 06604-3202 | 2014-10-24 |
| 1669877379 | Devana Campbell | Counselor | 15 Heritage Pl, Bridgeport, CT 06606-1314 | 2014-10-24 |
| 1760887475 | Pryndall Marie White | Counselor | 955 Main St Apt 906, Bridgeport, CT 06604-4319 | 2014-10-24 |
| 1669744611 | Tdat Transitional Development and Training | Counselor | 70 Lincoln Blvd, Bridgeport, CT 06606-5550 | 2012-02-07 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06604 |
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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.