Provider Demographics
NPI:1629145065
Name:COMMUNITY RENEWAL TEAM
Entity Type:Organization
Organization Name:COMMUNITY RENEWAL TEAM
Other - Org Name:JUDITH G HUNT LMFT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-714-9200
Mailing Address - Street 1:11 MOUNTAIN AVE
Mailing Address - Street 2:SUITE204
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-2343
Mailing Address - Country:US
Mailing Address - Phone:860-286-0528
Mailing Address - Fax:860-286-0585
Practice Address - Street 1:11 MOUNTAIN AVE
Practice Address - Street 2:SUITE204
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2343
Practice Address - Country:US
Practice Address - Phone:860-286-0528
Practice Address - Fax:860-286-0585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000586106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1629145065Other106H00000X