Healthcare Provider Details

I. General information

NPI: 1174476840
Provider Name (Legal Business Name): COMMUNITY SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BANK ST
PLAINVILLE CT
06062-2703
US

IV. Provider business mailing address

175 ADDISON RD STE 3
WINDSOR CT
06095-2179
US

V. Phone/Fax

Practice location:
  • Phone: 860-747-9930
  • Fax: 860-793-2231
Mailing address:
  • Phone: 860-683-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: NATHAN RUSSELL PROVOST
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 860-683-7153