Southbury Adolescent and Young Adult Counseling Center
NPI 1235737735 · Mental Health Counselor · Southbury, CT
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southbury Adolescent and Young Adult Counseling Center is a Mental Health Counselor organization in Southbury, CT (NPI 1235737735).
Provider details
- NPI number
- 1235737735
- Entity type
- Organization
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Brendan Stack, Owner, Lpc(518) 610-4528
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-10-15
- Last updated
- 2025-08-03
- Certified
- 2025-08-03
Frequently asked questions
- What is Southbury Adolescent and Young Adult Counseling Center's NPI number?
- Southbury Adolescent and Young Adult Counseling Center's National Provider Identifier (NPI) is 1235737735, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southbury Adolescent and Young Adult Counseling Center?
- Southbury Adolescent and Young Adult Counseling Center is classified in the NPPES registry as Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Southbury Adolescent and Young Adult Counseling Center located?
- Southbury Adolescent and Young Adult Counseling Center's practice location on file with NPPES is 519 Heritage Rd Ste 2a5, Southbury, CT 06488-6694.
- What is Southbury Adolescent and Young Adult Counseling Center's phone number?
- The practice phone number listed in the NPPES registry for Southbury Adolescent and Young Adult Counseling Center is (203) 568-5923.
- Does Southbury Adolescent and Young Adult Counseling Center accept Medicare?
- Southbury Adolescent and Young Adult Counseling Center is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southbury Adolescent and Young Adult Counseling Center?
- The authorized official listed on Southbury Adolescent and Young Adult Counseling Center's NPPES record is Brendan Stack, Owner, Lpc. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southbury Adolescent and Young Adult Counseling Center's NPI active?
- Yes — Southbury Adolescent and Young Adult Counseling Center's NPI (1235737735) is active in the NPPES registry as of the last update on 2025-08-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.