Provider Demographics
NPI:1629518303
Name:CENTRO UNO
Entity Type:Organization
Organization Name:CENTRO UNO
Other - Org Name:HELENA CHADA, PSYCHOTHERAPY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MASTER PSYCHOLO
Authorized Official - Phone:203-216-0578
Mailing Address - Street 1:149 WATER ST
Mailing Address - Street 2:SUITE 23
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854
Mailing Address - Country:US
Mailing Address - Phone:203-216-0578
Mailing Address - Fax:203-216-0578
Practice Address - Street 1:149 WATER ST
Practice Address - Street 2:SUITE 23
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854
Practice Address - Country:US
Practice Address - Phone:203-216-0578
Practice Address - Fax:203-216-0578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00136L101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT610L03215704017Medicaid