Healthcare Provider Details

I. General information

NPI: 1205960994
Provider Name (Legal Business Name): CAPITOL REGION EDUCATION COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 BLUE HILLS AVE
BLOOMFIELD CT
06002-1151
US

IV. Provider business mailing address

123 PROGRESS DR
WETHERSFIELD CT
06109-2450
US

V. Phone/Fax

Practice location:
  • Phone: 860-242-7834
  • Fax:
Mailing address:
  • Phone: 860-509-3770
  • Fax: 860-529-4868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number0382
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: HEATHER TARTAGLIA
Title or Position: DIRECTOR OF STUDENT SERVICES
Credential:
Phone: 860-509-3770