STATE OF CONNECTICUT (NPI# 1841225489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841225489 |
| Entity Type | Organization |
| Organization Name | STATE OF CONNECTICUT |
| Other Organization Name | WESTERN CONNECTICUT MENTAL HEALTH NETWORK |
| Practice Address |
55 West Main Street Suite 410 Rowland State Government Center Waterbury CT 06702 |
| Practice Telephone | 2038056403 |
| Practice Fax Number | 2038056432 |
| Mailing Telephone | 2038056403 |
| Mailing Fax Number | 2038056432 |
| 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 | 004217106 | 05 | |
| CT | 004120333 | 05 |
| Other Name | Type Code |
|---|---|
| Western Connecticut Mental Health Network | 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 |
| 1487689022 | State of Connecticut | Clinic/Center | 500 Vine Street, Hartford, CT 06112 | 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 |
55 WEST MAIN STREET SUITE 410 ROWLAND STATE GOVERNMENT CENTER |
| City | WATERBURY |
| State | CT |
| Zip Code | 06702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518139294 | Erik N Derouin | Social Worker | 55 West Main Street, Suite 410 Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2008-04-02 |
| 1174794499 | Carissa Countryman Eddy | Social Worker | 55 West Main Street, Suite 410 Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2008-03-14 |
| 1881739233 | Matthew Gordon Snow | Psychologist | 55 West Main Street, Suite 410, Waterbury, CT 06702 | 2007-02-21 |
| 1295871291 | Robert Milton Stubbs | Social Worker | 55 West Main Street, Suite 410, Waterbury, CT 06702 | 2007-01-29 |
| 1376689331 | Justin S Egan | Social Worker | 55 West Main Street, Western Connecticut Mental Health Network Suite 410, Waterbury, CT 06702 | 2007-01-29 |
| 1588722839 | Honey L Sammartano | Social Worker | 55 West Main Street, Suite 410, Waterbury, CT 06702 | 2006-12-05 |
| 1205902558 | Frank C Pinto | Social Worker | 55 West Main Street, Suite 410, Waterbury, CT 06702 | 2006-11-28 |
| 1023184371 | Paula Zigman | Social Worker | 55 West Main Street, Suite 410 Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-28 |
| 1558434530 | Cynthia Lynne Krozser | Social Worker | 55 West Main Street, Suite 410 Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-16 |
| 1396818381 | Catherine Evelyn Marzullo | Social Worker | 55 West Main Street, Suite 410 Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780120295 | Melitza Velez | Counselor | 80 Prospect St., Waterbury, CT 06702 | 2017-01-09 |
| 1467813600 | Ashley Joseph | Counselor | 30 Holmes Ave, Waterbury, CT 06702 | 2016-03-16 |
| 1649662313 | Lori Arens | Social Worker | 141 E Main St Fl 4, Waterbury, CT 06702 | 2015-03-04 |
| 1265725584 | Zelda Shleifer | Audiologist | 21 W Main St Fl Place-3, Waterbury, CT 06702 | 2011-05-19 |
| 1700024585 | Charlene Angela Jurgaitis | Durable Medical Equipment & Medical Supplies | 102 Grand Street, Waterbury, CT 06702 | 2009-02-02 |
| 1518090570 | Nathan Z Imre | Pharmacist | 161 East Main St Central Pharmacy, Waterbury, CT 06702 | 2007-03-13 |
| 1922149467 | Rachael A Petitti | Social Worker | 402 East Main Street, Waterbury, CT 06702 | 2007-02-09 |
| 1710024484 | Abbot Terrace Health Center | Assisted Living Facility | 44 Abbott Terrace, Waterbury, CT 06702 | 2007-01-31 |
| 1205994555 | Michael Arcangel Padilla | Social Worker | Western Connecticut Mental Health Network, 55 West Main Street Suite 410, Waterbury, CT 06702 | 2006-12-05 |
| 1205902723 | Colette M Anderson | Social Worker | 55 West Main St Suite 410, Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-27 |
| Find all providers in zip 06702 | ||||
| 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 |
|---|---|---|---|---|
| 1326246687 | Central Naugatuck Valley Help, Inc. | Clinic/Center | 900 Watertown Ave, Waterbury, CT 06708-2011 | 2007-07-10 |
| 1598764474 | Family Intervention Center, Inc | Clinic/Center | 22 Chase River Rd, Waterbury, CT 06704-1408 | 2005-07-21 |
| 1598279689 | Connecticut Counseling Centers Inc | Clinic/Center | 50 Brookside Rd, Waterbury, CT 06708-1402 | 2017-11-28 |
| 1316161193 | Waterbury Psychiatric Associates, P.C. | Clinic/Center | 133 Scovill St, Suite # 201, Waterbury, CT 06706-1127 | 2007-04-12 |
| 1982720702 | Connecticut Counseling Centers, Inc. | Clinic/Center | 4 Midland Rd, Waterbury, CT 06705-3412 | 2007-03-22 |
| 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 |
| 1750807426 | The Connection Inc | Clinic/Center | 37 Garden St, Hartford, CT 06105-2129 | 2017-08-15 |
| 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.