SOUTHWEST COMMUNITY HEALTH CENTER (NPI# 1407307119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407307119 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST COMMUNITY HEALTH CENTER |
| Practice Address |
1046 Fairfield Ave Bridgeport CT 06605 |
| Practice Telephone | 2033323105 |
| Practice Fax Number | 2033314716 |
| Mailing Telephone | 2033323105 |
| Mailing Fax Number | 2033314716 |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |
| Authorized Official Name | BRIAN BECKER (COUNSELOR) |
| Authorized Official Telephone | 2033323105 |
| Authorized Official Credential | PSY.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043618309 | Southwest Community Health Center | Voluntary or Charitable | 5705 W 65th St, Suite C, Little Rock, AR 72209-3827 | 2014-12-18 |
| 1821480989 | Southwest Community Health Center | Voluntary or Charitable | 7754 Sw Capitol Hwy, Portland, OR 97219-2477 | 2015-02-26 |
| 1528269131 | Southwest Community Health Center | Clinic/Center | 46 Albion St, Bridgeport, CT 06605-2602 | 2007-05-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SOUTHWEST COMMUNITY HEALTH CENTER | 7754 Sw Capitol Hwy, Portland, OR 97219-2477 |
| Oregon Corporations, Companies and Business Names | SOUTHWEST COMMUNITY HEALTH CENTER | 7754 Sw Capitol Hwy, Portland, OR 97219 |
| Connecticut Business Registrations | SOUTHWEST COMMUNITY HEALTH CENTER, INC. | 46 Albion Street, Bridgeport, CT 06605 |
| Street Address |
1046 FAIRFIELD AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932319555 | Robert Skane | Counselor | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2007-05-23 |
| 1306459094 | Andrea Cristina Rivadeneira | Counselor | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2020-08-24 |
| 1649814351 | Martha Catherina Velasco | Social Worker | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2019-11-06 |
| 1952945727 | Mara E Richardson | Social Worker | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2019-11-04 |
| 1023675873 | South- West Community Health Center, Inc | Clinic/Center | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2019-05-28 |
| 1043797020 | Tara Concetta O'neil | Social Worker | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2018-07-23 |
| 1639684111 | Julienne Gousse | Social Worker | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2017-12-06 |
| 1366951758 | Miranda Leah Demirjian | Social Worker | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2017-09-28 |
| 1316351521 | Richard Dunn | Counselor | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2014-06-16 |
| 1437592615 | Janet L Garris | Counselor | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2013-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497312276 | Stacy-ann Thompson-grant | Social Worker | 170 Bennet T Street, Bridgeport, CT 06605 | 2019-05-28 |
| 1720502149 | Sheree Amankwah | Counselor | 170 Bennett Street, Bridgeport, CT 06605 | 2017-07-27 |
| 1417477324 | Aracelis Robertson | Case Manager/Care Coordinator | 1646 Fairfield Avenue, 3rd Floor, Bridgeport, CT 06605 | 2017-06-21 |
| 1699158170 | Cortney Davis | Physician Assistant | 3250 Fairfield Ave, Unit 217, Bridgeport, CT 06605 | 2015-07-02 |
| 1083020051 | Douglas Mccoy | Nurse Practitioner | 46 Albion St., Bridgeport, CT 06605 | 2014-07-10 |
| 1932513785 | Hallie Claire Riggs | Social Worker | 1730 State St Ext, Bridgeport, CT 06605 | 2014-06-19 |
| 1831518513 | Yvonne Booy | Counselor | 46 Albion Street, Bridgeport, CT 06605 | 2014-04-10 |
| 1760556955 | Joel W Allen | Obstetrics & Gynecology | 625 Clinton Ave, Bridgeport, CT 06605 | 2006-11-20 |
| 1316046428 | Allen P Schlein | Orthopaedic Surgery | 650 Clinten Avenue, Bridgeport, CT 06605 | 2006-09-22 |
| 1336127984 | Hancock Pharmacy | Pharmacy | 1557 Fairfield Ave, Bridgeport, CT 06605 | 2006-01-04 |
| Find all providers in zip 06605 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467077149 | Valayshia T Brookins | Counselor | 1635 Capitol Ave # 2, Bridgeport, CT 06604-1525 | 2020-06-09 |
| 1720502149 | Sheree Amankwah | Counselor | 170 Bennett Street, Bridgeport, CT 06605 | 2017-07-27 |
| 1811380868 | Rachel S Sherman | Counselor | 7274 Dixie Hwy, Bridgeport, MI 48722-9702 | 2015-03-16 |
| 1083951388 | Henry Torres | Counselor | 1635 Central Ave Rm 427, Bridgeport, CT 06610-2717 | 2013-01-08 |
| 1063799187 | Ebony L Davidson | Counselor | 629 Jewett Ave, Bridgeport, CT 06606-2836 | 2011-11-03 |
| 1184888422 | Andro Kim Haws | Counselor | 111 Davisson St, Bridgeport, WV 26330 | 2008-07-16 |
| 1033320569 | Mary Elizabeth Mester | Counselor | St. Augustine's School, Bush & Rambo Sts, Bridgeport, PA 19405-1510 | 2007-05-25 |
| 1932319555 | Robert Skane | Counselor | 1046 Fairfield Ave, Bridgeport, CT 06605-1116 | 2007-05-23 |
| 1821208406 | Julie Marie Werner | Counselor | 112 Oakwood Circle, Bridgeport, WV 26554 | 2007-05-23 |
| 1003425588 | Patrice M Wolinski | Counselor | 7274 Dixie Hwy, Bridgeport, MI 48722-9702 | 2020-07-30 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06605 |
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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.