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Contact Information

THE FAMILY COUNSELING & MEDIATION CENTER, LLC
435 NEW HAVEN AVE
DERBY, CT06418-2534
 Phone: 203-736-6734
 Fax: 203-736-6734
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mental Health

101YM0800X
 

Marriage & Family Therapist

106H00000X
Indicates primary specialty

NPI Profile & details for THE FAMILY COUNSELING & MEDIATION CENTER, LLC

NPI Number 1245448323
LBN Legal business name THE FAMILY COUNSELING & MEDIATION CENTER, LLC
Authorized official KARLENE CHISHOLM - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/20/2007
Last updated 09/11/2025 - About 9 months ago
Identifiers
CT License # 001119
CT Other 7732883 AETNA
CT Other 410001119CT02 ANTHEM
CT Other 316439 MHN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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