Provider Demographics
NPI:1407909542
Name:THE CONNECTICUT CHILDREN AND FAMILY CENTER, INC.
Entity Type:Organization
Organization Name:THE CONNECTICUT CHILDREN AND FAMILY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LUCINEO
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:203-772-4228
Mailing Address - Street 1:230 ASHMUN ST # 4
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-3549
Mailing Address - Country:US
Mailing Address - Phone:203-772-4228
Mailing Address - Fax:203-776-1982
Practice Address - Street 1:230 ASHMUN ST # 4
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3549
Practice Address - Country:US
Practice Address - Phone:203-772-4228
Practice Address - Fax:203-776-1982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT50THECTCHCT01OtherANTHEM BLUE CROSS (AGENCY
CT309474OtherMHN
CT140001633CT02OtherANTHEM BLUE CROSS (LDC)
CT11241720OtherCAQH
CTN8Y14OtherEMPIRE