# STATE OF CONNECTICUT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** John Dempsey Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669466561
- **Authorized official:** JEFFREY GEOGHEGAN (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (860) 679-3162

## Contact information

- **Practice address:** 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-5355
- **Practice address phone:** (860) 679-2916
- **Practice address fax:** (860) 679-3071
- **Mailing address:** 263 FARMINGTON AVENUE, FARMINGTON, CT 06030-5355

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | 00065 | CT | — |
| 103T00000X | Psychologist | 00065 | CT | — |
| 1041C0700X | Clinical Social Worker | 00065 | CT | — |
| 207P00000X | Emergency Medicine Physician | — | CT | — |
| 261QE0002X | Emergency Care Clinic/Center | 00065 | CT | — |
| 282N00000X | General Acute Care Hospital | 00065 | CT | Yes |

## Other

- **Enumeration date:** 09/07/2005
- **Last updated:** 05/04/2023