| Beverly Chambers, | |
|
3 Main St Ste A, Centerbrook, CT 06409-1089 | |
| (860) 532-0604 | |
| Not Available |
| Full Name | Beverly Chambers |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 3 Main St Ste A, Centerbrook, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992375802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 004211 (Connecticut) | Primary |
| Entity Name | Gilead Community Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518948025 PECOS PAC ID: 0244289643 Enrollment ID: O20050112000765 |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Chambers, 25 Clover St, Middletown, CT 06457-5218 Ph: (860) 807-6971 | Beverly Chambers, 3 Main St Ste A, Centerbrook, CT 06409-1089 Ph: (860) 532-0604 |
Marjorie Meyer Siegel Russell, MS COUNSELING Counselor Medicare: Not Enrolled in Medicare Practice Location: 17 Industrial Park Rd, Centerbrook, CT 06409 Phone: 860-304-5107 | |
Anne Peterson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 90 Main St Ste 103b, Centerbrook, CT 06409 Phone: 860-767-0444 Fax: 860-767-0444 | |
Jacquelynn Russo-boudinot, LMFT, NCC, CDM Counselor Medicare: Not Enrolled in Medicare Practice Location: 90 Main St Ste 103a, Centerbrook, CT 06409 Phone: 860-510-6130 Fax: 860-760-6706 | |
Leslie Mallimson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 68 Main St, Centerbrook, CT 06409 Phone: 860-767-2266 Fax: 860-767-5067 |