Southbury Adolescent and Young Adult Counseling Center
NPI 1235737735ActiveOrganization· Counselor, Mental Health· Southbury, CT
Counselor, Mental Health in Southbury, Connecticut, registered in NPPES in October 2020. The authorized official on file is Brendan Stack, LPC, Owner, Lpc. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1235737735 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 15, 2020 |
| Last updated in NPPES | Aug 3, 2025 |
| Certified by provider | Aug 3, 2025 |
Specialties and licenses
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CT) |
|---|
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