| Chaise Lounge Counseling Llc | |
|
164 Hempstead St New London CT 06320-5638 | |
| (860) 237-3273 | |
| Not Available |
| Full Name | Chaise Lounge Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 164 Hempstead St, New London, Connecticut |
| Authorized Official Name and Position | Shayna Provencher (OWNER/PROVIDER) |
| Authorized Official Contact | 8602373273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaise Lounge Counseling Llc 112 New London Rd Unit 1-310 Groton CT 06340-4869 Ph: (860) 639-4893 | Chaise Lounge Counseling Llc 164 Hempstead St New London CT 06320-5638 Ph: (860) 237-3273 |
| NPI Number | 1477362168 |
|---|---|
| Provider Enumeration Date | 01/06/2025 |
| Last Update Date | 02/17/2025 |
| Certification Date | 02/17/2025 |
| Medicare PECOS PAC ID | 8527589969 |
|---|---|
| Medicare Enrollment ID | O20250303000524 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477362168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Shayna Elyse Provencher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801593199 PECOS PAC ID: 8729438163 Enrollment ID: I20231227000948 |
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