Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southbury Adolescent and Young Adult Counseling Center

Organization Addiction (Substance Use Disorder) Counselor · NPI 1235737735

Southbury Adolescent and Young Adult Counseling Center is an Addiction (Substance Use Disorder) Counselor in Southbury, Connecticut. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
7

Practice location Address checks out

519 Heritage Rd Ste 2A5
Southbury, CT 06488-6694
Phone: (203) 568-5923
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Professional Counselor Taxonomy 101YP2500X
Clinical Social Worker Taxonomy 1041C0700X
Speech-Language Pathologist Taxonomy 235Z00000X
Multi-Specialty Clinic/Center Taxonomy 261QM1300X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X

Record details

NPI number1235737735
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brendan Stack — Owner, Lpc · (518) 610-4528
NPI enumeratedOctober 15, 2020
Last updated in NPPESAugust 3, 2025
Certification dateAugust 3, 2025
Mailing address127 Watertown Rd, Middlebury, CT 06762-1502

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