| Catholic Charities, Inc. - Archdiocese Of Hartford | |
|
501 Lombard St. New Haven CT 06513 | |
| (203) 787-2207 | |
| (203) 773-3626 |
| Full Name | Catholic Charities, Inc. - Archdiocese Of Hartford |
|---|---|
| Speciality | Clinic/Center |
| Location | 501 Lombard St., New Haven, Connecticut |
| Authorized Official Name and Position | Rose Alma Senatore (CEO) |
| Authorized Official Contact | 8604931841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catholic Charities, Inc. - Archdiocese Of Hartford 839 Asylum Ave Hartford CT 06105-2801 Ph: () - | Catholic Charities, Inc. - Archdiocese Of Hartford 501 Lombard St. New Haven CT 06513 Ph: (203) 787-2207 |
| NPI Number | 1518051747 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 09/02/2008 |
| Medicare PECOS PAC ID | 2567367469 |
|---|---|
| Medicare Enrollment ID | O20040928000800 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518051747 | NPI | - | NPPES |
| 004040549 | Medicaid | CT | |
| 183459 | Other | CT | HEALTHNET/MHN |
| 77ABH0007CT | Other | CT | BC/BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gregory N Peterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619916962 PECOS PAC ID: 9830175736 Enrollment ID: I20040629001179 |
| Provider Name | Lisa C Diamond |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184710550 PECOS PAC ID: 6800924663 Enrollment ID: I20100514000692 |
| Provider Name | Monica Ann Starr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770868085 PECOS PAC ID: 5698906022 Enrollment ID: I20140815001393 |
| Provider Name | Tanya Ruth Bassett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801293824 PECOS PAC ID: 2961725031 Enrollment ID: I20141222000071 |
| Provider Name | Melina Infantino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295133411 PECOS PAC ID: 5698093524 Enrollment ID: I20150406000868 |
| Provider Name | Raymond Gunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932618568 PECOS PAC ID: 7113266495 Enrollment ID: I20190304002139 |
| Provider Name | Janine Laura Hitchens-parker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194295006 PECOS PAC ID: 2769722610 Enrollment ID: I20190313000372 |
| Provider Name | Janice Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548822000 PECOS PAC ID: 4284060526 Enrollment ID: I20200205002681 |
| Provider Name | Martell M Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982142808 PECOS PAC ID: 1254746027 Enrollment ID: I20210209002736 |
| Provider Name | Sherly Boulay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851766737 PECOS PAC ID: 0547648180 Enrollment ID: I20220609001887 |
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