National Provider Identifier Database

THE FAMILY COUNSELING MEDIATION CENTER LLC
Mental Health


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
* Mental Health 101YM0800X
Marriage & Family Therapist 106H00000X

* Indicates primary specialty

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

NPI Number 1245448323
Legal business name
LBN
THE FAMILY COUNSELING & MEDIATION CENTER, LLC
Authorized official KARLENE CHISHOLM - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/20/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • CT License #: 001119
  • CT Other: 7732883 AETNA
  • CT Other: 410001119CT02 ANTHEM
  • CT Other: 316439 MHN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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