COMMUNITY RENEWAL TEAM (NPI# 1669542379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669542379 |
| Entity Type | Organization |
| Organization Name | COMMUNITY RENEWAL TEAM |
| Practice Address |
675 Tower Ave Hartford CT 06112-1260 |
| Mailing Address |
15 Balaban Rd Colchester CT 06415-1701 |
| Practice Telephone | 8607143729 |
| Mailing Telephone | 8605376100 |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2007-07-26 |
| Authorized Official Name | LENA RODRIGUEZ (CEO) |
| Authorized Official Telephone | 8605605600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 000827 | CT | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 000172 | CT | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881853034 | Community Renewal Team | Social Worker | 949 Pleasant Valley Rd Apt 4-12, South Windsor, CT 06074-4237 | 2008-06-03 |
| 1124397518 | Community Renewal Team | Counselor | 1921 Park St, Hartford, CT 06106-2118 | 2011-12-14 |
| 1053613752 | Community Renewal Team | Case Management | 675 Tower Ave, 303, Hartford, CT 06112-1273 | 2010-12-01 |
| 1679748628 | Community Renewal Team | Social Worker | 675 Tower Ave, Mob, Suite 308, Hartford, CT 06112-1273 | 2008-04-29 |
| 1629145065 | Community Renewal Team | Marriage & Family Therapist | 11 Mountain Ave, Suite204, Bloomfield, CT 06002-2343 | 2006-11-29 |
| Street Address |
675 TOWER AVE |
| City | HARTFORD |
| State | CT |
| Zip Code | 06112-1260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467448878 | Kimberly L Beaulieu | Physician Assistant | 675 Tower Ave, Hartford, CT 06112-1264 | 2005-09-21 |
| 1053833475 | Mona Anne Chiurillo | Nurse Practitioner | 675 Tower Ave, Hartford, CT 06112-1273 | 2017-07-07 |
| 1457758179 | Shivanna Subramani Gonzalez | Nurse Practitioner | 675 Tower Ave, Hartford, CT 06112-1273 | 2014-11-24 |
| 1750626032 | Melissa Leigh Costanzo | Marriage & Family Therapist | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2012-11-28 |
| 1477846319 | Susana L Mealha | Social Worker | 675 Tower Ave, Suite 303, Hartford, CT 06112-1273 | 2011-05-25 |
| 1396038691 | Javeeria Manzoor | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2011-05-18 |
| 1912204504 | Elaine F Pratt | Nurse Practitioner | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2011-02-17 |
| 1053613752 | Community Renewal Team | Case Management | 675 Tower Ave, 303, Hartford, CT 06112-1273 | 2010-12-01 |
| 1144522160 | Community Renewal Team Inc. | Case Management | 675 Tower Ave, Hartford, CT 06451 | 2010-11-23 |
| 1154638815 | Mahreen Raza | Psychiatry & Neurology | 675 Tower Ave, Suite 301, Hartford, CT 06112-1273 | 2010-09-01 |
| 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 | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376163725 | Faerieland LLC | Community/Behavioral Health | 470 Edgewood St Fl 2, Hartford, CT 06112-1917 | 2020-04-24 |
| 1528691524 | Smith Counseling and Consulting Services, LLC | Community/Behavioral Health | 39 Natick St, Hartford, CT 06106-4029 | 2020-02-18 |
| 1528610979 | Storybook Counseling LLC | Community/Behavioral Health | 664 Prospect Ave Fl 22nd, Hartford, CT 06105-4203 | 2019-07-15 |
| 1679031140 | Phetsamon Dilullo | Community/Behavioral Health | 25 Clermont St, Hartford, CT 06106-3904 | 2019-03-04 |
| 1821563099 | Frank Ngo | Community/Behavioral Health | 39 Allendale Rd, Hartford, CT 06106-3502 | 2018-10-03 |
| 1669919130 | Capitol Region Education Council | Community/Behavioral Health | 15 Van Dyke Ave, Crec Two Rivers High School, Hartford, CT 06106-2879 | 2017-01-23 |
| 1801348016 | Nalej of Self | Community/Behavioral Health | 19 Arlington St, Hartford, CT 06106-4004 | 2016-11-04 |
| 1093185050 | Kathleen M. Friend Lmft LLC | Community/Behavioral Health | 1 Congress St Ste 210, Hartford, CT 06114-1067 | 2015-10-03 |
| 1396159786 | Self Injury Awareness Network, Inc. | Community/Behavioral Health | 18-20 Trinity St, C/o Ct Asian Pacific American Commission, Hartford, CT 06106-1600 | 2014-06-13 |
| 1508143819 | Northend Counseling Center | Community/Behavioral Health | 261 Barbour St, Hartford, CT 06120-1705 | 2011-11-15 |
| Find all providers in HARTFORD | ||||
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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.