| Ms Bernice V Malachi, | |
|
1310 Main St, Willimantic, CT 06226-1910 | |
| (860) 731-5522 | |
| (860) 731-5536 |
| Full Name | Ms Bernice V Malachi |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1310 Main St, Willimantic, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891113056 | NPI | - | NPPES |
| 004235918 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Entity Name | Intercommunity Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073548533 PECOS PAC ID: 9032001649 Enrollment ID: O20040329000218 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Bernice V Malachi, 2 Waterside Xing Ste 401, Windsor, CT 06095-1588 Ph: (860) 697-3351 | Ms Bernice V Malachi, 1310 Main St, Willimantic, CT 06226-1910 Ph: (860) 731-5522 |
William Bergmann, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1491 Main St, Willimantic, CT 06226 Phone: 860-456-3215 | |
Elicia L Jones, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 890-731-5536 | |
Ms. Jessica M Diaz, MASTER OF ARTS Counselor Medicare: Not Enrolled in Medicare Practice Location: 132 Mansfield Ave, Willimantic, CT 06226 Phone: 860-456-2261 | |
Ning Cruzado, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 860-731-5536 | |
Amanda Church, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 860-731-5536 | |
Kelly M Shepard, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 890-731-5536 | |
Felicia Ca Martin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1310 Main St, Willimantic, CT 06226 Phone: 860-731-5522 Fax: 890-731-5536 |