CONNECTICUT VALLEY ADDICTION RECOVERY, INC (NPI# 1750932646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750932646 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT VALLEY ADDICTION RECOVERY, INC |
| Practice Address |
141 Etta Frasier Dr Windsor VT 05089-1315 |
| Practice Telephone | 8026749400 |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2019-09-23 |
| Authorized Official Name | DR. CLIFTON F LORD (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8026749400 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CONNECTICUT VALLEY ADDICTION RECOVERY, INC. | 141 Etta Frasier Dr, Windsor, VT 05089-1315 |
| Street Address |
141 ETTA FRASIER DR |
| City | WINDSOR |
| State | VT |
| Zip Code | 05089-1315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639381668 | Connecticut Valley Recovery Services, Inc. | Internal Medicine | 141 Etta Frasier Dr, Windsor, VT 05089-1315 | 2007-05-03 |
| 1164046173 | Leah Beth Siegel | Physician Assistant | 141 Etta Frasier Dr, Windsor, VT 05089-1315 | 2020-06-04 |
| 1063066538 | Ashley Hutton | Counselor | 141 Etta Frasier Dr, Windsor, VT 05089-1315 | 2019-08-01 |
| 1851850432 | Owen Murray | Marriage & Family Therapist | 141 Etta Frasier Dr, Windsor, VT 05089-1315 | 2019-03-13 |
| 1023529864 | Katrina M. Whyman | Counselor | 141 Etta Frasier Dr, Windsor, VT 05089-1315 | 2017-10-19 |
| 1316209109 | Karen D Mcginty | Social Worker | 141 Etta Frasier Dr, Windsor, VT 05089 | 2012-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235307133 | Jennifer Ann Grimes | Occupational Therapy Assistant | 49 Cedar Hill Drive, Windsor, VT 05089 | 2008-02-13 |
| 1689870180 | Lisa J Amodeo | Physical Therapist | 49 Cedar Hill Ln, Windsor, VT 05089 | 2007-06-22 |
| 1760448450 | Mary K Joyce | Family Medicine | 289 County Rd, Mt Ascutney Physician Practices, Windsor, VT 05089 | 2006-04-22 |
| 1417277674 | Windsor Chiropractic Associates | Chiropractor | 15 State St, Windsor, VT 05089-1201 | 2010-06-10 |
| 1497828859 | Clifton Frederick Lord | Internal Medicine | 15 State St, Windsor, VT 05089-1201 | 2006-11-15 |
| 1962519108 | Lauren D Mcclure | Family Medicine | 15 State St, Windsor, VT 05089-1201 | 2006-08-24 |
| 1417254772 | Caitlin S Woodbury | Chiropractor | 20 State St, Windsor, VT 05089-1202 | 2011-02-23 |
| 1568000362 | Willows of Windsor | Custodial Care Facility | 121 State St, Windsor, VT 05089-1213 | 2019-12-12 |
| 1922130236 | State Street Enterprise, LLC | Assisted Living Facility | 45 State St, Windsor, VT 05089-1213 | 2007-03-12 |
| 1710070115 | Cecily M. Monro | Psychologist | 287 County Rd, Windsor, VT 05089-1261 | 2006-09-30 |
| Find all providers in zip 05089 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639381668 | Connecticut Valley Recovery Services, Inc. | Internal Medicine | 141 Etta Frasier Dr, Windsor, VT 05089-1315 | 2007-05-03 |
| 1497828859 | Clifton Frederick Lord | Internal Medicine | 15 State St, Windsor, VT 05089-1201 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003117078 | Mark E Logan Md PC | Internal Medicine | 199 Stratton Rd, Rutland, VT 05701-4621 | 2010-11-08 |
| 1447208269 | William Bradford Hoge Bissell | Internal Medicine | 160 Allen Street, Rutland Regional Medical Center, Rutland, VT 05701 | 2006-05-04 |
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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.