STATE OF CONNECTICUT (NPI# 1225063860) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225063860 |
| Entity Type | Organization |
| Organization Name | STATE OF CONNECTICUT |
| Other Organization Name | PROBLEM GAMBLING SERVICES |
| Practice Address |
2 Vance Drive Russell Hall Connecticut Valley Hospital Middletown CT 06457 |
| Mailing Address |
Po Box 351 2 Vance Drive Russell Hall Connecticut Valley Hospital Middletown CT 06457 |
| Practice Telephone | 8602626601 |
| Practice Fax Number | 8603442360 |
| Mailing Telephone | 8602626601 |
| Mailing Fax Number | 8603442360 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DAVID ALBEA CROMPTON (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 |
| Other Name | Type Code |
|---|---|
| Problem Gambling Services | 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 |
| 1841225489 | State of Connecticut | Clinic/Center | 55 West Main Street, Suite 410 Rowland State Government Center, Waterbury, CT 06702 | 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 |
2 VANCE DRIVE RUSSELL HALL CONNECTICUT VALLEY HOSPITAL |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| 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 |
|---|---|---|---|---|
| 1104426436 | A New Beginning Counseling | Clinic/Center | 410 N Ramunno Dr Unit 312, Middletown, DE 19709-3090 | 2020-10-27 |
| 1033404025 | The Connection, Inc. | Clinic/Center | 100 Roscommon Dr, Middletown, CT 06457-1591 | 2011-06-17 |
| 1952442725 | The Connection Inc. | Clinic/Center | 196 Court St, Middletown, CT 06457-3302 | 2007-02-12 |
| 1427074426 | State of Connecticut | Clinic/Center | Silver Street, Dutton Home, Middletown, CT 06457 | 2006-07-14 |
| 1518948025 | Gilead Community Services, Inc. | Clinic/Center | 230 Main Street Ext, Middletown, CT 06457-4470 | 2005-11-10 |
| 1609351477 | Pax Treatment Centers LLC | Clinic/Center | 4302 Roosevelt Blvd, Middletown, OH 45044-6625 | 2018-09-27 |
| 1861911455 | Small Victories Wellness Services, Pllc | Clinic/Center | 424 High St, Middletown, CT 06457-2633 | 2017-09-14 |
| 1124405709 | River Rock Psychiatry, LLC | Clinic/Center | 11 S Main St, Ste 2, Middletown, CT 06457-3656 | 2015-05-02 |
| 1225339666 | The Connection Inc. | Clinic/Center | 955 S Main St, Middletown, CT 06457-5153 | 2010-11-16 |
| 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 | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
Please comment or provide details below to improve the information on STATE OF CONNECTICUT.
| 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.