STATE OF CONNECTICUT (NPI# 1487689022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487689022 |
| Entity Type | Organization |
| Organization Name | STATE OF CONNECTICUT |
| Other Organization Name | CAPITOL REGION MENTAL HEALTH CENTER |
| Practice Address |
500 Vine Street Hartford CT 06112 |
| Practice Telephone | 8602970975 |
| Practice Fax Number | 8602970914 |
| Mailing Telephone | 8602970975 |
| Mailing Fax Number | 8602970914 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2016-03-16 |
| Authorized Official Name | MR. STEPHEN A DIPIETRO (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 8604186923 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004215150 | 05 | |
| CT | 004139433 | 05 |
| Other Name | Type Code |
|---|---|
| Capitol Region Mental Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871095851 | State of Connecticut | Clinic/Center | 850 Bolton Rd Unit 1271, Storrs, CT 06269-1271 | 2018-03-06 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1790974657 | State of Connecticut | Durable Medical Equipment & Medical Supplies | 381 Hopmeadow Street, Simsbury, CT 06070 | 2007-10-17 |
| 1205951662 | State of Connecticut | Skilled Nursing Facility | 287 West Street, Rocky Hill, CT 06067-3904 | 2007-03-21 |
| 1750459855 | State of Connecticut | Psychiatric Residential Treatment Facility | 915 River Road, Middletown, CT 06457-3921 | 2006-11-30 |
| 1427074426 | State of Connecticut | Clinic/Center | Silver Street, Dutton Home, Middletown, CT 06457 | 2006-07-14 |
| 1366477903 | State of Connecticut | Psychiatric Hospital | 525 Russell Rd, Newington, CT 06111 | 2006-07-12 |
| 1841225489 | State of Connecticut | Clinic/Center | 55 West Main Street, Suite 410 Rowland State Government Center, Waterbury, CT 06702 | 2006-07-12 |
| 1225063860 | State of Connecticut | Clinic/Center | 2 Vance Drive Russell Hall, Connecticut Valley Hospital, Middletown, CT 06457 | 2006-07-12 |
| 1871524678 | State of Connecticut | Ambulance | Route 172, Dept of Mental Retardation: Southbury Training School, Southbury, CT 06488-0901 | 2006-07-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | STATE OF CONNECTICUT DMR | 460 Capitol Ave, Hartford, CT 06106-1308 |
| Street Address |
500 VINE STREET |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285039628 | Margarita Gonzalez | Social Worker | 500 Vine Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2014-10-28 |
| 1609200823 | Roina Kidd-beason | Social Worker | 500 Vine Street, Capital Region Mental Health Center, Hartford, CT 06112 | 2013-08-23 |
| 1144662156 | Susan Joan Meunier | Nurse Practitioner | 500 Vine Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2013-07-19 |
| 1942649033 | Capitol Region Mental Health Center | Psychiatric Hospital | 500 Vine Street, Capitol Region Mental Health Center Pharmacy, Hartford, CT 06112 | 2013-06-21 |
| 1114363264 | Patricia D Fredette | Social Worker | 500 Vine Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2013-05-16 |
| 1588917132 | Liane A Flynn | Social Worker | 500 Vine Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2012-10-19 |
| 1609143023 | Haydee Emperatriz Ciudad-mercado | Social Worker | 500 Vine Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2011-11-30 |
| 1760764005 | Ivette M. Suarez-bonilla | Social Worker | 500 Vine Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2011-09-13 |
| 1730394198 | Valerie R. Martin | Social Worker | 500 Vine Street, Capitol Region Mental Health Center, Hartford, CT 06112-2232 | 2007-05-11 |
| 1730219403 | Irshad Ahmed | Psychiatry & Neurology | 500 Vine Street, Capital Region Mental Health Center, Hartford, CT 06112 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841810355 | Ashwin Mahesh | Student in an Organized Health Care Education/Training Program | 131 Coventry Street, 2nd Floor, Burgdorf Clinic, Hartford, CT 06112 | 2020-04-24 |
| 1336600527 | Waleed Ibrahim | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic, 131 Coventry Street 2nd Floor, Hartford, CT 06112 | 2019-03-29 |
| 1740741941 | Hajra Munawar | Student in an Organized Health Care Education/Training Program | Burgdorf Clinic 131 Coventry Street, Hartford, CT 06112 | 2019-03-29 |
| 1194191973 | Esther Wint | Nurse Practitioner | 490 Blue Ave, Hartford, CT 06112 | 2015-08-17 |
| 1194105700 | Michelle Russi | Physical Therapy Assistant | 490 Blue Hill Ave., Hartford, CT 06112 | 2015-06-09 |
| 1366858359 | Krysten N Marotta | Pharmacist | 1290 Albany Ave, Hartford, CT 06112 | 2014-07-10 |
| 1447403522 | Moon Hee Yoo | Psychiatry & Neurology | 500 Vine St., Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1992958094 | Roxann Marie Ellis-denby | Social Worker | 51 Coventry Street, Capitol Region Mental Health Center, Hartford, CT 06112 | 2008-11-03 |
| 1265590871 | The Connecticut Institute for The Blind | Intermediate Care Facility, Mentally Retarded | 120 Holcomb Street, Hartford, CT 06112 | 2006-12-05 |
| 1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
| Find all providers in zip 06112 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750807426 | The Connection Inc | Clinic/Center | 37 Garden St, Hartford, CT 06105-2129 | 2017-08-15 |
| 1841551553 | Catholic Charities | Clinic/Center | 220 Grandview Ter, Hartford, CT 06114-2209 | 2012-05-30 |
| 1477601367 | Alcohol & Drug Recovery Centers, Inc | Clinic/Center | 16 Coventry St, Hartford, CT 06112-1524 | 2007-01-08 |
| 1164580379 | Intercommunity, Inc. | Clinic/Center | 16 Coventry Street, Hartford, CT 06112 | 2006-12-04 |
| 1033750526 | Healing Waters/life Changers LLC | Clinic/Center | 1229 Albany Ave Ste 4, Hartford, CT 06112-2156 | 2019-10-05 |
| 1487026183 | Actsinc | Clinic/Center | 151 New Park Ave, Suite 120, Hartford, CT 06106-2170 | 2015-10-21 |
| 1063812527 | Carole Mackenzie Lcsw | Clinic/Center | 674 Prospect Ave, Hartford, CT 06105-4288 | 2014-09-02 |
| 1417398041 | Y-us, Inc. | Clinic/Center | 1477 Park St, 1st Floor, Hartford, CT 06106-2235 | 2013-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841816956 | Angela Olivia Roberts, Aprn, LLC | Clinic/Center | 427 Naubuc Ave Ste 101, Glastonbury, CT 06033-1082 | 2020-06-24 |
| 1437708708 | Clean Rxeach LLC | Clinic/Center | 1506 Post Rd Ste 4, Fairfield, CT 06824-5916 | 2019-09-09 |
| 1447812250 | Camellia Place Healthcare Services LLC | Clinic/Center | 100 Market Sq Ste 12, Newington, CT 06111-2921 | 2019-07-01 |
| 1427616077 | Therigatha Center for Psychotherapy | Clinic/Center | 68 Bridge St Unit 301, Suffield, CT 06078-3108 | 2019-05-30 |
| 1942864145 | Cynthia Leavitt, LLC | Clinic/Center | 39 New London Tpke Ste 316, Glastonbury, CT 06033-2061 | 2019-04-24 |
| 1285108498 | Lana Lachance LLC | Clinic/Center | 346 Main St S Fl 2, Woodbury, CT 06798-3409 | 2019-01-22 |
| 1295215093 | Mindful Therapy Studio LLC | Clinic/Center | 16 Rae Palmer Road, Moodus, CT 06423 | 2018-08-21 |
| 1356831960 | Connecticut Counseling Centers Inc | Clinic/Center | 15 Commerce Rd Lowr 1, Stamford, CT 06902-4553 | 2018-05-18 |
| 1780189480 | Connecticut Counseling Centers, Inc. | Clinic/Center | 290 Pratt St Ste 2312, Meriden, CT 06450-8600 | 2018-03-26 |
| 1285154468 | Shepard Meadows Therapeutic Riding Center, Inc. | Clinic/Center | 733 Hill St, Bristol, CT 06010-2243 | 2017-06-20 |
| 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.