| Evolve Brain Health Llc | |
|
1055 Summer St Stamford CT 06905-5527 | |
| (203) 504-9758 | |
| (203) 504-9758 |
| Full Name | Evolve Brain Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1055 Summer St, Stamford, Connecticut |
| Authorized Official Name and Position | Thomas Joseph Knightly (OWNER) |
| Authorized Official Contact | 9788571424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolve Brain Health Llc 1055 Summer St Ste 2 Stamford CT 06905-5527 Ph: (203) 504-9758 | Evolve Brain Health Llc 1055 Summer St Stamford CT 06905-5527 Ph: (203) 504-9758 |
| NPI Number | 1740916105 |
|---|---|
| Provider Enumeration Date | 07/28/2022 |
| Last Update Date | 09/30/2024 |
| Certification Date | 09/30/2024 |
| Medicare PECOS PAC ID | 9537538244 |
|---|---|
| Medicare Enrollment ID | O20221219001900 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740916105 | NPI | - | NPPES |
| Provider Name | Julianne Vesciglio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295355360 PECOS PAC ID: 2163838962 Enrollment ID: I20210302002226 |
| Provider Name | Thomas Knightly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447771282 PECOS PAC ID: 6901176320 Enrollment ID: I20221219002025 |
| Provider Name | Sheilah Noya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710669718 PECOS PAC ID: 1557707080 Enrollment ID: I20240307000169 |
| Provider Name | Kristofer Generales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124706635 PECOS PAC ID: 5799212205 Enrollment ID: I20241223001657 |
| Provider Name | Oksana Fuller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174300636 PECOS PAC ID: 4789112541 Enrollment ID: I20250108001452 |
Healing Journey Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 85 Mayapple Rd, Stamford, CT 06903 Phone: 607-727-7049 | |
Fitability Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 Buxton Farm Rd Ste 230, Stamford, CT 06905 Phone: 203-212-4191 | |
Jessica Vivenzio, Lcsw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 68 Hope St Apt 11, Stamford, CT 06906 Phone: 413-531-5788 | |
Child & Adolescent Therapy Associates Of Fairfield County, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 53 Albin Rd, Stamford, CT 06902 Phone: 203-515-1249 | |
Arches, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1266 E Main St, #700r, Stamford, CT 06902 Phone: 646-761-9661 | |
Rappore Medicine Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Stamford Plz Fl 9, Stamford, CT 06901 Phone: 212-564-0480 | |
Nh Therapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 984 Stillwater Rd, Stamford, CT 06902 Phone: 646-258-0237 |