CONNECTICUT RENAISSANCE, INC (NPI# 1265449359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265449359 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT RENAISSANCE, INC |
| Practice Address |
4 Byington Pl Norwalk CT 06850-3309 |
| Mailing Address |
1 Waterview Dr Ste 202 Shelton CT 06484-4368 |
| Practice Telephone | 2038662541 |
| Practice Fax Number | 2038545682 |
| Mailing Telephone | 2033365225 |
| Mailing Fax Number | 2033362851 |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-07-08 |
| Authorized Official Name | JOY NICOLE PENDOLA (COO) |
| Authorized Official Telephone | 2033365225 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | Y |
| Parent Organization Name | CONNECTICUT RENAISSANCE, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004138914 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649321696 | Connecticut Renaissance, Inc | Substance Abuse Rehabilitation Facility | 31 Wolcott St, Waterbury, CT 06702-1727 | 2007-01-16 |
| 1598817140 | Connecticut Renaissance, Inc | Substance Abuse Rehabilitation Facility | 466 W Main St, Waterbury, CT 06702-1123 | 2007-01-16 |
| 1770634719 | Connecticut Renaissance, Inc | Counselor | 705 Bloomfield Ave, Suite 102, Bloomfield, CT 06002-2404 | 2007-01-16 |
| 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 |
4 BYINGTON PL |
| City | NORWALK |
| State | CT |
| Zip Code | 06850-3309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497234421 | Francis Xavier Berardi | Counselor | 4 Byington Pl, Norwalk, CT 06850-3309 | 2018-08-10 |
| 1134490998 | Virginia Palmer Ayres | Counselor | 4 Byington Pl, Norwalk, CT 06850-3309 | 2012-01-25 |
| 1689945479 | Christina Trani | Counselor | 4 Byington Pl, Norwalk, CT 06850-3309 | 2012-01-25 |
| 1689945438 | Melodie Keen | Counselor | 4 Byington Pl, Norwalk, CT 06850-3309 | 2012-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497105092 | Brightview Norwalk, LLC | Alzheimer Center (Dementia Center) | 162 New Canaan Ave., Norwalk, CT 06850 | 2016-06-15 |
| 1518321306 | Megan Yee | Social Worker | 54 W. Norwalk Road, Norwalk, CT 06850 | 2016-04-08 |
| 1992129886 | Alicia Collen Zeidan | Nurse Practitioner | 10 Mott Ave Ste 2a, Norwalk, CT 06850 | 2014-02-12 |
| 1306194642 | Diane Beth Weiss | Specialist | 12 Rae Lane, Norwalk, CT 06850 | 2012-08-16 |
| 1538491170 | Thomas C. Santaniello | Dentist | 16 River Street, Norwalk, CT 06850 | 2010-02-08 |
| 1720226988 | Kathleen F Dayton | Counselor | 4 Berkeley Street, Super Kids, Norwalk, CT 06850 | 2009-01-27 |
| 1578716783 | Helen B. Mccue | Social Worker | 9 Mott Avenue, Family and Children's Agency, Norwalk, CT 06850 | 2008-10-31 |
| 1609900497 | James Schumacher | Physician Assistant | Maple Avenue, Norwalk, CT 06850 | 2007-03-15 |
| 1134270002 | Neelam Narula | Nurse Practitioner | 34 Maple St Ste J, Norwalk, CT 06850 | 2007-01-16 |
| 1669559951 | Patricia Jorquera | Pediatrics | 10 Mott Avenue, 4th Floor, Norwalk, CT 06850 | 2006-11-01 |
| Find all providers in zip 06850 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093913154 | Harris Counseling LLC | Clinic/Center | 128 East Avenue, Fourth Floor, Norwalk, CT 06851 | 2007-07-10 |
| 1457369399 | Los Angeles County Department of Mental Health | Clinic/Center | 12440 East Imperial Hwy., Suite #116, Norwalk, CA 90650-8347 | 2006-08-04 |
| 1467476804 | Los Angeles County Department of Mental Health | Clinic/Center | 12440 Imperial Hwy Ste 116, Norwalk, CA 90650-8347 | 2006-07-27 |
| 1215552708 | Amani Nia Therapeutic Services Pllc | Clinic/Center | 64 Wall St Ste 306, Norwalk, CT 06850-3403 | 2020-06-10 |
| 1770122947 | Spirit Clinic LLC | Clinic/Center | 64 Wall St Ste 306, Norwalk, CT 06850-3403 | 2020-01-05 |
| 1205313947 | Dorye Jackson LLC | Clinic/Center | 50 Washington St, Norwalk, CT 06854-2710 | 2018-07-25 |
| 1811266901 | Los Angeles County Department of Mental Health | Clinic/Center | 12440 Firestone Blvd., 3rd Fl Ste 3001, Norwalk, CA 90650-4328 | 2011-12-20 |
| 1144510694 | Connecticut Renaissance, Inc. | Clinic/Center | 17 High St, Norwalk, CT 06851-4723 | 2011-04-18 |
| 1770727208 | Telecare Los Angeles Adult Services | Clinic/Center | 12440 Firestone Blvd, Suite 3025, Norwalk, CA 90650-4328 | 2009-04-28 |
| 1932340981 | Kathryn F. Nuro, Ph.d., LLC | Clinic/Center | 128 East Ave, Norwalk, CT 06851-5738 | 2009-03-19 |
| Find all providers in NORWALK | ||||
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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.