BREAKWATER COUNSELING CENTER, LLC (NPI# 1821592072) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821592072 |
| Entity Type | Organization |
| Organization Name | BREAKWATER COUNSELING CENTER, LLC |
| Practice Address |
1110 Broadbridge Ave Stratford CT 06615-5801 |
| Practice Telephone | 2036931169 |
| Mailing Telephone | 2036931169 |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2019-07-24 |
| Authorized Official Name | JOANNE MARTIN (OWNER/COUNSELOR) |
| Authorized Official Telephone | 2036931169 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BEACON HEALTH | CBHP009329 | 01 |
| CT | STATE OF CT DPH | 003183 | 01 |
| Street Address |
1110 BROADBRIDGE AVE |
| City | STRATFORD |
| State | CT |
| Zip Code | 06615-5801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154713832 | Lauren Pessin | Behavioral Analyst | 55 Sutton Ave, Stratford, CT 06615 | 2015-03-04 |
| 1801223748 | Steven Flathers | Occupational Therapist | 27 Eunice Parkway, Stratford, CT 06615 | 2013-10-10 |
| 1700219243 | Stratford Orthodontics | Dentist | 2499 Main Street, Stratford, CT 06615 | 2013-08-20 |
| 1417380981 | Debra L Tomaselli | Marriage & Family Therapist | 2296 Main Street, 2nd Floor, Stratford, CT 06615 | 2013-08-19 |
| 1003199217 | Katherine Bajda | Nurse Practitioner | 837 Prospect Drive, Stratford, CT 06615 | 2011-09-23 |
| 1336326495 | Dammy Bamisile | Social Worker | 100 Center Street, Shelton, CT 06615 | 2008-01-30 |
| 1487868550 | Mark Rabin | Medical Genetics, Ph.D. Medical Genetics | Dianon Systems, 200 Watson Boulevard, Stratford, CT 06615 | 2007-05-09 |
| 1205958675 | Sophia Leonida M.d., PC | Clinic/Center | 2505 Main St., Stratford, CT 06615 | 2007-04-04 |
| 1558488213 | Fatima Eslami-varzaneh | Pathology | 200 Watson Boulvard, Stratford, CT 06615 | 2007-03-26 |
| 1881729804 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 555 Lordship Boulevard, Stratford, CT 06615 | 2007-02-22 |
| Find all providers in zip 06615 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265903223 | Silvia Dicovich, LLC | Counselor | 3241 Main St Ste B, Stratford, CT 06614-4850 | 2018-12-16 |
| 1285189902 | Tameria Macari | Counselor | 3095 Main St, 2nd Floor, Stratford, CT 06614-4852 | 2016-08-23 |
| 1083068308 | New Hope Therapy, LLC | Counselor | 2875 Main St Ste 2, Stratford, CT 06614-4979 | 2016-04-22 |
| 1497137665 | Silagy Family Counseling Center LLC | Counselor | 54 Allyndale Dr, Stratford, CT 06614-5101 | 2015-06-24 |
| 1841695558 | Christopher Albino | Counselor | 379a Piute Ln, Stratford, CT 06614-6104 | 2014-10-24 |
| 1083016703 | Elizabeth Rose Damon | Counselor | 4021 Main St, 1f, Stratford, CT 06614-3568 | 2014-09-24 |
| 1679984785 | Virtue Health, LLC | Counselor | 195 Albright Ave, Stratford, CT 06614-3064 | 2014-05-12 |
| 1255652004 | Carlita Freni | Counselor | 42 E. Laurel Road, Suite 1100, Cares, Stratford, NJ 08084 | 2010-06-16 |
| 1508972399 | Paulette Iris Powell-reeves | Counselor | 2874 Main St, Suite 2 E, Second Floor, Stratford, CT 06614-4957 | 2006-08-22 |
| 1558389486 | Tomichan P Aprame | Counselor | 2505 Main St Ste 208, Stratford, Stratford, CT 06615-5813 | 2006-07-18 |
| Find all providers in STRATFORD | ||||
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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.