LIBERATION PROGRAMS INC (NPI# 1316060940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316060940 |
| Entity Type | Organization |
| Organization Name | LIBERATION PROGRAMS INC |
| Other Organization Name | LIBERATION MERIDIAN GUENSTER |
| Practice Address |
399 Mill Hill Ave Bridgeport CT 06610-2865 |
| Mailing Address |
4 Elmcrest Ter Norwalk CT 06850-3908 |
| Practice Telephone | 8888222270 |
| Practice Fax Number | 2033364395 |
| Mailing Telephone | 2038512077 |
| Mailing Fax Number | 2038512082 |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ALAN MATHIS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2038512077 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0290 | CT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BLUECROSS BLUESHIELD | 42B | 01 |
| CT | BLUECROSS BLUESHIELD | 77ABH0051CT01 | 01 |
| Other Name | Type Code |
|---|---|
| Liberation Meridian Guenster | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174644652 | Liberation Programs Inc | Clinic/Center | 120 Brookside Road, Darien, CT 06820 | 2007-04-03 |
| 1316067481 | Liberation Programs Inc | Clinic/Center | 399 Mill Hill Ave, Bridgeport, CT 06610-2865 | 2007-03-30 |
| 1346360443 | Liberation Programs Inc | Clinic/Center | 55 Old Field Point Rd, Greenwich, CT 06830-6149 | 2007-03-30 |
| 1528241189 | Liberation Programs Inc | Substance Abuse Rehabilitation Facility | 119 Main St, Stamford, CT 06901-2818 | 2007-12-06 |
| 1750562989 | Liberation Programs Inc | Substance Abuse Rehabilitation Facility | 141 Franklin St, Stamford, CT 06901-1014 | 2007-11-15 |
| 1942323571 | Liberation Programs Inc | Counselor | 115 Main St, Stamford, CT 06901-2818 | 2007-04-09 |
| 1851414486 | Liberation Programs Inc | Counselor | 115 Main St, Stamford, CT 06901-2818 | 2007-04-09 |
| 1407978356 | Liberation Programs Inc | Clinic/Center | 115 Main St, Stamford, CT 06901-2818 | 2007-04-04 |
| 1649390733 | Liberation Programs Inc | Clinic/Center | 115 Main St, Stamford, CT 06901-2818 | 2007-03-30 |
| Street Address |
399 MILL HILL AVE |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-2865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316067481 | Liberation Programs Inc | Clinic/Center | 399 Mill Hill Ave, Bridgeport, CT 06610-2865 | 2007-03-30 |
| 1538557624 | Amond Tillman | Counselor | 399 Mill Hill Ave, Bridgeport, CT 06610-2865 | 2014-12-26 |
| 1518207117 | Samantha U Bathija | Counselor | 399 Mill Hill Ave, Bridgeport, CT 06610-2865 | 2013-02-20 |
| 1275775215 | Patricia Joan Smith | Clinical Nurse Specialist | 399 Mill Hill Ave, Bridgeport, CT 06610-2865 | 2009-04-06 |
| 1457553513 | Hansa H Shah | Counselor | 399 Mill Hill Ave, Bridgeport, CT 06610-2865 | 2007-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215553698 | Juan G Farfan | Nurse Anesthetist, Certified Registered | 267 Grant Sreet, Bridgeport, CT 06610 | 2020-06-22 |
| 1104446145 | Deepak Rajkumar Vangipuram | Student in an Organized Health Care Education/Training Program | Department of Medicine, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-20 |
| 1275152886 | Soniya Abraham | Student in an Organized Health Care Education/Training Program | Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2020-04-14 |
| 1538621834 | Yu Mi Kang | Student in an Organized Health Care Education/Training Program | 267 Grant Street, Yale New Haven Health/bridgeport Hosp, Bridgeport, CT 06610 | 2019-04-04 |
| 1073075024 | Ashwin Pramod Deshmukh | Student in an Organized Health Care Education/Training Program | Yale New Haven Health / Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610 | 2019-04-01 |
| 1790246866 | Prachi Mangesh Pednekar | Student in an Organized Health Care Education/Training Program | Yale New Haven Health/bridgeport Hospital, 261 Grant Street Department of Internal Medicine, Bridgeport, CT 06610 | 2019-03-29 |
| 1194247916 | Jessica M. Maddern | Social Worker | 1558 Barnum Avenue, Building C, Bridgeport, CT 06610 | 2017-07-13 |
| 1922532746 | Megha Kureti | Student in an Organized Health Care Education/Training Program | 267 Grant St Fl 3, Bridgeport, CT 06610 | 2017-04-18 |
| 1831623099 | Cynthia Joseph Walters | Nurse Anesthetist, Certified Registered | Bridgeport Hospital-anesthesia Department, 267 Grant Street, Bridgeport, CT 06610 | 2017-04-14 |
| 1285186148 | Helen Leahy | Nurse Practitioner | 439 Mill Hill Ave., Bridgeport, CT 06610 | 2016-10-26 |
| Find all providers in zip 06610 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952912271 | Patience Ashong | Counselor | 191 High Ridge Dr, Bridgeport, CT 06606-4965 | 2020-08-11 |
| 1871133371 | Pamela Mcmahon | Counselor | 3851 Main St Fl 2, Bridgeport, CT 06606-2864 | 2020-01-13 |
| 1922580737 | Jacqueline Renee Scott | Counselor | 566 Wilmot Ave Unit 1, Bridgeport, CT 06607-1107 | 2018-08-29 |
| 1225556418 | Louis L Reed | Counselor | 3334 Main St, Bridgeport, CT 06606-4227 | 2017-09-07 |
| 1609396951 | Eleanora Morgan | Counselor | 336 Midland St, Bridgeport, CT 06605-3546 | 2017-06-27 |
| 1316487630 | Louis L. Reed | Counselor | 189 Smith St, Bridgeport, CT 06607-2220 | 2017-03-06 |
| 1003288168 | Jacqueline Rodriguez | Counselor | 243 Success Ave, Bridgeport, CT 06610-2429 | 2015-10-28 |
| 1487024238 | Onorio Dadamo | Counselor | 350 Fairfield Ave, Bridgeport, CT 06604-6014 | 2015-10-05 |
| 1588985584 | Fritz Maignan | Counselor | 48 Alpine St, Bridgeport, CT 06610-1727 | 2010-06-14 |
| 1942453287 | Darrin Allan Mcallister | Counselor | 289 Laurel Ave, Bridgeport, CT 06605-1102 | 2008-10-30 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06610 |
Please comment or provide details below to improve the information on LIBERATION PROGRAMS INC.
| 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.