BRENDAN STACK (NPI# 1316403892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316403892 |
| Entity Type | Individual |
| Full Name | BRENDAN STACK |
| Credential | LPC, LADC |
| Practice Address |
5 Brookside Ave # 2 Winsted CT 06098-1101 |
| Mailing Address |
45 Greenwich Dr Southbury CT 06488-2122 |
| Practice Telephone | 5186104528 |
| Mailing Telephone | 5186104528 |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2020-07-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
001323 | CT | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
4530 | CT | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 45 Greenwich Dr, Southbury, CT 064882122 | 5186104528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093725475 | Brendan Curran Stack | Dentist | 8306 Old Courthouse Rd, Suite A, Vienna, VA 22182-3844 | 2006-08-09 |
| 1437165164 | Brendan Curran Stack Jr. | Otolaryngology | 720 N Bond St, Springfield, IL 62702-4952 | 2006-08-01 |
| Street Address |
5 BROOKSIDE AVE # 2 |
| City | WINSTED |
| State | CT |
| Zip Code | 06098-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548354012 | William P Ryan | Dentist | 10 Hinsdale Ave, Winsted, CT 06098 | 2006-10-02 |
| 1417966078 | Mark E Stefanov | Dentist | 17 Union St, Winsted, CT 06098 | 2006-08-05 |
| 1154354256 | Theodore Francis Marolda | Dentist | 16 Hinsdale Ave, Winsted, CT 06098 | 2006-07-09 |
| 1407354095 | Northwestern Dental | Dentist | 101 North Main Street, Winsted, CT 06098 | 2018-01-29 |
| 1588187348 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 200 New Hartford Rd, Winsted, CT 06098 | 2017-07-24 |
| 1093909871 | David R Lawrence Md LLC | Internal Medicine | 200 New Hartford Rd, Winsted, CT 06098 | 2007-09-05 |
| 1487792305 | Kim Marie Wasko | Dentist | 140 Willow St, Ste 2, Winsted, CT 06098 | 2007-02-02 |
| 1306852736 | David Robert Lawrence | Internal Medicine | 200 New Hartford Rd, Winsted, CT 06098 | 2006-07-31 |
| 1053374348 | Carol Hahn | Physical Therapist | 115 Spencer St, Winsted, CT 06098 | 2006-04-09 |
| 1245396282 | Ruth P Lallier | Social Worker | 214 Wallens Hill, Winsted, CT 06098-0098 | 2006-12-27 |
| Find all providers in zip 06098 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699863829 | Linda T Schroeder | Counselor | 15 Spencer St, Winsted, CT 06098-1113 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225013 | Madison Kathleen Reimondo | Counselor | 185 Silas Deane Hwy Ste 2, Wethersfield, CT 06109-1219 | 2020-11-06 |
| 1336740935 | Art Therapy Explorations LLC | Counselor | 23 Temple St, New Haven, CT 06510-2714 | 2020-11-02 |
| 1992303853 | Steps Counseling LLC | Counselor | 182 Candlewyck Dr, Newington, CT 06111-5229 | 2020-10-13 |
| 1578170965 | Elizabeth Ferguson | Counselor | 183 Montowese St Ste G, Branford, CT 06405-3869 | 2020-09-29 |
| 1912514605 | Well Beyond Counseling Pllc | Counselor | 2 Tunxis Rd Ste 201, Tariffville, CT 06081-9687 | 2020-09-26 |
| 1033725510 | Bianca Mcdaniel | Counselor | 1652 Meriden Rd Apt 22, Waterbury, CT 06705-3922 | 2020-09-20 |
| 1639784358 | Laura Sanford | Counselor | 107 Godek Hill Rd, Meriden, CT 06451-5081 | 2020-09-10 |
| 1669086799 | Berry Family Psychotherapy, LLC | Counselor | 27 White Rd, Middletown, CT 06457-2321 | 2020-09-05 |
| 1548874092 | Catherine Kimball | Counselor | 386 Cotton Hill Rd, New Hartford, CT 06057-3402 | 2020-09-02 |
| 1871106674 | Mindful Vision Counseling | Counselor | 304 W Main St Ste 21057, Avon, CT 06001-4355 | 2020-08-31 |
| 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.