COMMUNITY CHILD GUIDANCE CLINIC, INC. (NPI# 1780730267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780730267 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CHILD GUIDANCE CLINIC, INC. |
| Practice Address |
317 N Main St Manchester CT 06042-2007 |
| Practice Telephone | 8606432101 |
| Practice Fax Number | 8606451470 |
| Mailing Telephone | 8606432101 |
| Mailing Fax Number | 8606451470 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2013-05-03 |
| Authorized Official Name | MR. CLIFFORD JOHNSON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8606432101 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | 0238 | CT | Ambulatory Health Care Facilities |
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
OPCC-14 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004039277 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | COMMUNITY CHILD GUIDANCE CLINIC, INC. | 317 North Main St., Manchester, CT 06042 |
| Street Address |
317 N MAIN ST |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06042-2007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457958548 | Jamie Dann | Counselor | 317 N Main St, Manchester, CT 06042-2007 | 2020-10-02 |
| 1255822698 | Amina Hosaini | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2018-05-22 |
| 1104315456 | Jocelyn Flores | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2018-05-02 |
| 1386132512 | Christopher Mcdowell | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2018-04-24 |
| 1376030668 | Ian Francis Macdonald | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2018-04-23 |
| 1871949057 | Robin Entress | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2016-05-06 |
| 1053765735 | Ilaya L. Velaquez | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2016-04-19 |
| 1265803407 | Shannon Boivin | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2015-10-14 |
| 1770954919 | Patricia Saltzman | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2015-10-14 |
| 1669885307 | Shante Powers-gaskins | Social Worker | 317 N Main St, Manchester, CT 06042-2007 | 2014-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000960 | Nicole Berger | Behavioral Analyst | 199 Tudor Lane, Apartment E, Manchester, CT 06042 | 2018-10-31 |
| 1902336522 | Karen Scandura | Pharmacist | 260 North Main Street, Manchester, CT 06042 | 2017-06-15 |
| 1053727479 | Sph3enterprise, LLC | Dentist | 194 Buckland Hills Drive, Manchester, CT 06042 | 2014-07-07 |
| 1962657288 | Anthony Michael Gioscia | Optometrist | 344v Buckland Hills Dr, Manchester, CT 06042 | 2008-12-01 |
| 1467635714 | Linda Fernald Gates | Dietitian, Registered | 300 Parker St, Manchester, CT 06042 | 2007-12-10 |
| 1669513909 | Carlos Alfonso Gonzalez | Psychiatry & Neurology | 317 North Main Street, C/o Ccgc, Manchester, CT 06042 | 2007-02-09 |
| 1942350467 | Lise G. O'neill | Counselor | Manchester Memorial Hospital, 71 Haynes St, Manchester, CT 06042 | 2007-01-10 |
| 1558439398 | Jason Allen Sousa | Chiropractor | 1127 Tolland Turnpike, Suite 102, Manchester, CO 06042 | 2006-12-01 |
| 1245332444 | Sharon Soria | Dentist | 192 Main Street, Manchester, TN 06042 | 2006-09-01 |
| 1699732206 | First Choice Health Centers, Inc. | Clinic/Center | 150 N Main St Ste 240, Manchester, CT 06042 | 2006-04-27 |
| Find all providers in zip 06042 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295256840 | B.e.a.u.t.y, LLC | Clinic/Center | 824 Main St Ste F, Manchester, CT 06040-6048 | 2017-07-05 |
| 1306934757 | Pastoral Counseling Services-united Church of Christ, Inc. | Clinic/Center | 2013 Elm St, Manning House, Manchester, NH 03104-2528 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780195339 | Rachel Collins, Lpc | Clinic/Center | 410 State St Rm 1, North Haven, CT 06473-3149 | 2017-10-22 |
| 1376054148 | Joann Flynn LLC. | Clinic/Center | 3 Swanswood Ln, Old Lyme, CT 06371-1867 | 2017-10-19 |
| 1942723036 | Kellys Kids, Inc | Clinic/Center | 9 Spring Rd, Prospect, CT 06712-1522 | 2017-07-20 |
| 1518413442 | Community Partners In Action | Clinic/Center | 995 Sherman Ave, Hamden, CT 06514-1144 | 2016-08-31 |
| 1952760803 | Darbonshire, LLC | Clinic/Center | 304 Wahackme Rd, New Canaan, CT 06840-3936 | 2016-02-21 |
| 1760738025 | Psychologist Adriana L Gonzalez Phd Pllc | Clinic/Center | 85 Hillcrest Terrace, Meriden, CT 06450 | 2012-07-24 |
| 1497025035 | Ct Clinical Services, Inc. | Clinic/Center | 189 Orange St, New Haven, CT 06510-2014 | 2012-01-12 |
| 1093950032 | Yale Parenting and Child Conduct Clinic | Clinic/Center | 314 Prospect St, New Haven, CT 06511-2187 | 2008-12-04 |
| 1710185731 | Waterford Country School, Inc. | Clinic/Center | 78 Hunts Brook Rd, Quaker Hill, CT 06375-1009 | 2007-07-11 |
| 1689887440 | The Bridge Family Center Inc | Clinic/Center | 1022 Farmington Ave, West Hartford, CT 06107 | 2007-05-08 |
| Find all providers with the same taxonomy | ||||
| City | MANCHESTER |
| Zip Code | 06042 |
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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.