SOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER LLC (NPI# 1235737735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235737735 |
| Entity Type | Organization |
| Organization Name | SOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER LLC |
| Practice Address |
385 Main St S Ste 217 Southbury CT 06488-4246 |
| Mailing Address |
45 Greenwich Dr Southbury CT 06488-2122 |
| Practice Telephone | 5186104528 |
| Mailing Telephone | 5186104528 |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |
| Authorized Official Name | MR. BRENDAN STACK (OWNER) |
| Authorized Official Telephone | 5186104528 |
| Authorized Official Credential | LPC, LADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | SOUTHBURY ADOLESCENT AND YOUNG ADULT COUNSELING CENTER LLC | 45 Greenwich Drive, Southbury, CT 06488 |
| Street Address |
385 MAIN ST S STE 217 |
| City | SOUTHBURY |
| State | CT |
| Zip Code | 06488-4246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538646229 | Katherine Whalen | Physical Therapist | 655 Main Sreet South, Southbury, CT 06488 | 2018-07-25 |
| 1346779618 | Prestige Companion & Homemakers, LLC | Homemaker | 32 Poverty Rd, Suite F, Southbury, CT 06488 | 2017-06-08 |
| 1407225873 | Mary Synnott | Occupational Therapist | 25 Depot Hill Rd, Southbuty, CT 06488 | 2015-09-16 |
| 1568854735 | Jean Piacenza | Social Worker | 505 Heritage Road, Suite 104, Southbury, CT 06488 | 2015-02-25 |
| 1295174993 | Saeeda Qadri | Internal Medicine | 22 Old Waterbury Rd Ste 108, Southbury, CT 06488 | 2013-06-17 |
| 1538502133 | Hearing Aid Services Inc | Audiologist-Hearing Aid Fitter | 1449 Old Waterbury Rd Ste 303, Southbury, CT 06488 | 2013-04-12 |
| 1992064380 | Maria Hornak-houle | Social Worker | 88 Main St. S, Southbury, CT 06488 | 2012-05-07 |
| 1255641072 | Rebecha Kay Sullivan | Social Worker | 35 Timberland Way, Southbury, CT 06488 | 2010-10-14 |
| 1619115094 | Jennie L Kempf | Counselor | 33 Bullet Hill Rd Ste 204, Southbury, CT 06488 | 2009-01-23 |
| 1891949434 | Kelly Patrice Hochstetler | Occupational Therapist | 22 Old Waterbury Rd., Suite 101, Phys. Med. Ctr. of Southbury, Southbury, CT 06488 | 2008-11-10 |
| Find all providers in zip 06488 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982105128 | Mindful Guidance and Counseling LLC | Counselor | 2 Pomperaug Office Park Ste 206c, Southbury, CT 06488-2292 | 2018-02-23 |
| 1548427891 | Patricia B. Sobolewski | Counselor | 582c Heritage Vlg, Southbury, CT 06488-5432 | 2008-05-22 |
| 1013049139 | Kevin Keane | Counselor | 150 Bridle Path Rd, Southbury, CT 06488-2437 | 2007-03-12 |
| 1205967072 | Southbury-middlebury Youth & Family Services | Counselor | 1287 Strongtown Rd, Southbury, CT 06488 | 2007-03-07 |
| 1720119506 | Holly Poglitsch | Counselor | 385 Main Street South, Union Square Suite 215 2nd Fl., Southbury, CT 06488 | 2007-03-07 |
| 1174019640 | Valerie Candela Brower | Counselor | 250 Main St S, Southbury, CT 06488-2263 | 2018-07-07 |
| 1215238191 | Lori B Capri | Counselor | 1287 Strongtown Rd, Southbury, CT 06488-1948 | 2010-11-09 |
| 1386854826 | Karen Bobowick | Counselor | One Reservoir Office Park, Suite 306 D, Southbury, CT 06488 | 2007-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225013 | Madison Kathleen Reimondo | Counselor | 185 Silas Deane Hwy Ste 2, Wethersfield, CT 06109-1219 | 2020-11-06 |
| 1336740935 | Art Therapy Explorations LLC | Counselor | 23 Temple St, New Haven, CT 06510-2714 | 2020-11-02 |
| 1992303853 | Steps Counseling LLC | Counselor | 182 Candlewyck Dr, Newington, CT 06111-5229 | 2020-10-13 |
| 1578170965 | Elizabeth Ferguson | Counselor | 183 Montowese St Ste G, Branford, CT 06405-3869 | 2020-09-29 |
| 1912514605 | Well Beyond Counseling Pllc | Counselor | 2 Tunxis Rd Ste 201, Tariffville, CT 06081-9687 | 2020-09-26 |
| 1033725510 | Bianca Mcdaniel | Counselor | 1652 Meriden Rd Apt 22, Waterbury, CT 06705-3922 | 2020-09-20 |
| 1639784358 | Laura Sanford | Counselor | 107 Godek Hill Rd, Meriden, CT 06451-5081 | 2020-09-10 |
| 1669086799 | Berry Family Psychotherapy, LLC | Counselor | 27 White Rd, Middletown, CT 06457-2321 | 2020-09-05 |
| 1548874092 | Catherine Kimball | Counselor | 386 Cotton Hill Rd, New Hartford, CT 06057-3402 | 2020-09-02 |
| 1871106674 | Mindful Vision Counseling | Counselor | 304 W Main St Ste 21057, Avon, CT 06001-4355 | 2020-08-31 |
| 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.