| Natchaug Hospital, Inc. | |
|
189 Storrs Road Mansfield Center CT 06250-1683 | |
| (860) 456-1311 | |
| (860) 450-0165 |
| Full Name | Natchaug Hospital, Inc. |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 189 Storrs Road, Mansfield Center, Connecticut |
| Authorized Official Name and Position | Paul V Maloney (CFO) |
| Authorized Official Contact | 8604561311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Natchaug Hospital, Inc. 189 Storrs Road Mansfield Center CT 06250-1683 Ph: (860) 456-1311 | Natchaug Hospital, Inc. 189 Storrs Road Mansfield Center CT 06250-1683 Ph: (860) 456-1311 |
| NPI Number | 1295811321 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 04/10/2013 |
| Medicare PECOS PAC ID | 5395648737 |
|---|---|
| Medicare Enrollment ID | O20040202000008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295811321 | NPI | - | NPPES |
| 004041992 | Medicaid | CT | |
| 004121159 | Medicaid | CT | |
| 069 | Other | CT | ANTHEM BC BS |
| 004025276 | Medicaid | CT |
| Provider Name | Rajesh Parekh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710045992 PECOS PAC ID: 6204733637 Enrollment ID: I20031215000641 |
| Provider Name | Nancy G Miner |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1487772943 PECOS PAC ID: 7911994397 Enrollment ID: I20040428000167 |
| Provider Name | Farid Force |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952318669 PECOS PAC ID: 3779574322 Enrollment ID: I20040521000445 |
| Provider Name | Alexander P Miano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932211612 PECOS PAC ID: 2961488127 Enrollment ID: I20040628000996 |
| Provider Name | Sharon Hinton |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1871646141 PECOS PAC ID: 2264404284 Enrollment ID: I20040810001289 |
| Provider Name | Peter A Sugerman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871651901 PECOS PAC ID: 4082682133 Enrollment ID: I20040917000267 |
| Provider Name | Andrea C Reischerl |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1073821187 PECOS PAC ID: 8921064130 Enrollment ID: I20041208000918 |
| Provider Name | Eugenia I Popescu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285605071 PECOS PAC ID: 9335175082 Enrollment ID: I20050713000902 |
| Provider Name | Catalin Pralea |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225126014 PECOS PAC ID: 1658309406 Enrollment ID: I20050802000630 |
| Provider Name | Salvatore Iacobello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225128333 PECOS PAC ID: 1052338183 Enrollment ID: I20051028000144 |
| Provider Name | Ann Therese Haydu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225108509 PECOS PAC ID: 9032137906 Enrollment ID: I20051109000440 |
| Provider Name | Teodora Andrei |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912065715 PECOS PAC ID: 3476596842 Enrollment ID: I20060120000729 |
| Provider Name | Lynn C Winther |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245206556 PECOS PAC ID: 8224043500 Enrollment ID: I20060207000875 |
| Provider Name | Susan C Daly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396797858 PECOS PAC ID: 7315966595 Enrollment ID: I20060717000335 |
| Provider Name | Numan Gharaibeh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265428544 PECOS PAC ID: 3173593274 Enrollment ID: I20061229000379 |
| Provider Name | Nancy P Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376674721 PECOS PAC ID: 2668563438 Enrollment ID: I20070808000425 |
| Provider Name | Courtney M Malcolm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093909525 PECOS PAC ID: 8527138817 Enrollment ID: I20080529000187 |
| Provider Name | Cara D Riddle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194924373 PECOS PAC ID: 1557432010 Enrollment ID: I20080611000645 |
| Provider Name | Kerri L Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245273887 PECOS PAC ID: 9931271178 Enrollment ID: I20080703000587 |
| Provider Name | Concepcion Cortes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679765275 PECOS PAC ID: 2062585623 Enrollment ID: I20080716000119 |
| Provider Name | Kathleen A Mccarvell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154500981 PECOS PAC ID: 5193898419 Enrollment ID: I20080721000244 |
| Provider Name | Robert E Khalil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205083359 PECOS PAC ID: 1557420551 Enrollment ID: I20081105000714 |
| Provider Name | Joseph E Podolski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225221732 PECOS PAC ID: 3870653041 Enrollment ID: I20081118000183 |
| Provider Name | Trista Samuelson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932359668 PECOS PAC ID: 3375605819 Enrollment ID: I20081217000689 |
| Provider Name | Peter G Gasparo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114188869 PECOS PAC ID: 5294890430 Enrollment ID: I20090223000132 |
| Provider Name | Naomi Mendelovicz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487710141 PECOS PAC ID: 3577598218 Enrollment ID: I20090507000584 |
| Provider Name | Steven G Spector |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619181674 PECOS PAC ID: 1456401694 Enrollment ID: I20090610000470 |
| Provider Name | Mark Schroeder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417011198 PECOS PAC ID: 1456496652 Enrollment ID: I20100818000262 |
| Provider Name | Deborah A Weidner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114964327 PECOS PAC ID: 3072639897 Enrollment ID: I20100929000328 |
| Provider Name | Kenneth Dardick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316930266 PECOS PAC ID: 3274664305 Enrollment ID: I20101011000562 |
| Provider Name | Pamela L Shuman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265409031 PECOS PAC ID: 6507050028 Enrollment ID: I20101028001275 |
| Provider Name | Ayaz T Madraswalla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902899859 PECOS PAC ID: 5092846121 Enrollment ID: I20101110000003 |
| Provider Name | Alan Schmerler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396711495 PECOS PAC ID: 2769670140 Enrollment ID: I20101229000697 |
| Provider Name | Paul Edward Weigle |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184631384 PECOS PAC ID: 4486621521 Enrollment ID: I20110323000510 |
| Provider Name | Irshad Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730219403 PECOS PAC ID: 7012191851 Enrollment ID: I20110404000008 |
| Provider Name | Robert F. Grant |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720229024 PECOS PAC ID: 1456537265 Enrollment ID: I20110512000067 |
| Provider Name | Gayle S Klein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356540512 PECOS PAC ID: 7810165560 Enrollment ID: I20110722000547 |
| Provider Name | Carlos A Enciso Chaves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669635645 PECOS PAC ID: 1759551450 Enrollment ID: I20110908001689 |
| Provider Name | Kavetha Sundaramoorthy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447459052 PECOS PAC ID: 2961695515 Enrollment ID: I20110914000653 |
| Provider Name | Jane B Sofair |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811946494 PECOS PAC ID: 4587626916 Enrollment ID: I20120206000376 |
| Provider Name | Jonathan M Raub |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992962708 PECOS PAC ID: 1951448596 Enrollment ID: I20120517000341 |
| Provider Name | Shirley E Mohren-graves |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1568461465 PECOS PAC ID: 7012902810 Enrollment ID: I20120628000179 |
| Provider Name | Nayyara Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275844987 PECOS PAC ID: 6103082581 Enrollment ID: I20120731000005 |
| Provider Name | Carol Aprn Whelan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902963325 PECOS PAC ID: 9638326424 Enrollment ID: I20120830000122 |
| Provider Name | Kemmarie C Beal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780914374 PECOS PAC ID: 6800044793 Enrollment ID: I20120919000005 |
| Provider Name | Naila Azhar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477714376 PECOS PAC ID: 9931358058 Enrollment ID: I20121005000166 |
| Provider Name | Serita Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417203142 PECOS PAC ID: 2062661085 Enrollment ID: I20121009000005 |
| Provider Name | Lisa Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013295575 PECOS PAC ID: 1456501139 Enrollment ID: I20121016000448 |
| Provider Name | James R Doran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942249610 PECOS PAC ID: 5698701548 Enrollment ID: I20121113000430 |
| Provider Name | Trisha L Pesce |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730387499 PECOS PAC ID: 0547412348 Enrollment ID: I20121130000001 |
| Provider Name | Katharine N Woods |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639481955 PECOS PAC ID: 6608028022 Enrollment ID: I20121212000037 |
| Provider Name | Paulina D Kitcher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710962089 PECOS PAC ID: 6709778335 Enrollment ID: I20131205000414 |
| Provider Name | Alberto L Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588959068 PECOS PAC ID: 0143457705 Enrollment ID: I20131206000030 |
| Provider Name | Ruby E Lekwauwa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801186101 PECOS PAC ID: 5496984338 Enrollment ID: I20140219000043 |
| Provider Name | Onojeta E Ohwevwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023360377 PECOS PAC ID: 9335362037 Enrollment ID: I20140528000617 |
| Provider Name | Barbara C Pottinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194135335 PECOS PAC ID: 1355561200 Enrollment ID: I20140929000528 |
| Provider Name | Samuel T Wilkinson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265736169 PECOS PAC ID: 8729208400 Enrollment ID: I20140930002746 |
| Provider Name | Gerard G Gagne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861437477 PECOS PAC ID: 2466406277 Enrollment ID: I20141104000739 |
| Provider Name | Akinola Mobolaji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083022594 PECOS PAC ID: 3476875576 Enrollment ID: I20141126001556 |
| Provider Name | Lesley-ann Bernard-pantin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851515951 PECOS PAC ID: 1153412531 Enrollment ID: I20150109000117 |
| Provider Name | Halina D Dombkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215330436 PECOS PAC ID: 7113243841 Enrollment ID: I20150224000453 |
| Provider Name | Marilise A Hyacinth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528324530 PECOS PAC ID: 0648596163 Enrollment ID: I20150227001242 |
| Provider Name | Jennifer Staehly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215325097 PECOS PAC ID: 9739405960 Enrollment ID: I20150306001137 |
| Provider Name | Glenn Konopaske |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386613354 PECOS PAC ID: 3779474200 Enrollment ID: I20150921002268 |
| Provider Name | Champakamala H Rajanna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598044133 PECOS PAC ID: 9335382639 Enrollment ID: I20160302000567 |
| Provider Name | Sara Sala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417243676 PECOS PAC ID: 3779882857 Enrollment ID: I20160422001940 |
| Provider Name | Kimberly C Riquelme |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619282191 PECOS PAC ID: 9830486471 Enrollment ID: I20160924000209 |
| Provider Name | Dorothy Kozakowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588909196 PECOS PAC ID: 7113160847 Enrollment ID: I20161130000170 |
| Provider Name | Gengyun Wen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215367081 PECOS PAC ID: 8224318365 Enrollment ID: I20161207002573 |
| Provider Name | Mona C Daye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619140316 PECOS PAC ID: 3072640085 Enrollment ID: I20161213001304 |
| Provider Name | Marisa A Singleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952618720 PECOS PAC ID: 8527295708 Enrollment ID: I20170221000064 |
| Provider Name | Michele Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326573312 PECOS PAC ID: 0345527768 Enrollment ID: I20170511001480 |
| Provider Name | Mario Caro Sabogal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679846109 PECOS PAC ID: 1557663895 Enrollment ID: I20170713001585 |
| Provider Name | Madhav V Soni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114230794 PECOS PAC ID: 1052530342 Enrollment ID: I20170906002459 |
| Provider Name | Aimee C Eaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376068387 PECOS PAC ID: 2062786510 Enrollment ID: I20170921001473 |
| Provider Name | Hung V Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518223395 PECOS PAC ID: 7315231396 Enrollment ID: I20170929000277 |
| Provider Name | Yun Feng |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356781710 PECOS PAC ID: 7911214150 Enrollment ID: I20171010000962 |
| Provider Name | Muhammad N Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609280262 PECOS PAC ID: 1658646831 Enrollment ID: I20171016000040 |
| Provider Name | Clifford Kye |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629457072 PECOS PAC ID: 2062778640 Enrollment ID: I20171115000781 |
| Provider Name | Bentley A Strockbine |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003106709 PECOS PAC ID: 4284927385 Enrollment ID: I20171120002856 |
| Provider Name | Carrie B Vargas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700949617 PECOS PAC ID: 2769579739 Enrollment ID: I20180117001172 |
| Provider Name | Caroline N Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154746352 PECOS PAC ID: 2567687585 Enrollment ID: I20180122001264 |
| Provider Name | Andrea C Reischerl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073821187 PECOS PAC ID: 8921064130 Enrollment ID: I20180201001811 |
| Provider Name | Geraldine Tookey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215922901 PECOS PAC ID: 8628245677 Enrollment ID: I20180219000076 |
| Provider Name | Joanna P Chaurette |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457748816 PECOS PAC ID: 9931460474 Enrollment ID: I20180226002405 |
| Provider Name | Maria Ghanbari Motlagh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023370186 PECOS PAC ID: 5193086361 Enrollment ID: I20180302002363 |
| Provider Name | Caroline B E Polsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164888202 PECOS PAC ID: 3072875160 Enrollment ID: I20180330000834 |
| Provider Name | Shakaib Naseem Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134561335 PECOS PAC ID: 4880956812 Enrollment ID: I20180402002019 |
| Provider Name | Jean Gauvin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689801912 PECOS PAC ID: 6002066909 Enrollment ID: I20180423000432 |
| Provider Name | Hung-teh Kao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326282468 PECOS PAC ID: 8022155753 Enrollment ID: I20180427001973 |
| Provider Name | Ashley F Coughlin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528445871 PECOS PAC ID: 3779847579 Enrollment ID: I20180502002353 |
| Provider Name | Emma E Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609240787 PECOS PAC ID: 5991069353 Enrollment ID: I20180510002287 |
| Provider Name | Emily Poloji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922491349 PECOS PAC ID: 8729351564 Enrollment ID: I20180511001193 |
| Provider Name | Michaela A Dumais |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831531243 PECOS PAC ID: 4981848090 Enrollment ID: I20180522000095 |
| Provider Name | Manu Suresh Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457761587 PECOS PAC ID: 3072868058 Enrollment ID: I20180614002139 |
| Provider Name | Irene Kay Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851682736 PECOS PAC ID: 6709063480 Enrollment ID: I20180618000792 |
| Provider Name | Sarah E Long |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144631037 PECOS PAC ID: 3476849548 Enrollment ID: I20180718000926 |
| Provider Name | Kartik Pattabiraman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174978662 PECOS PAC ID: 9032406632 Enrollment ID: I20180904002932 |
| Provider Name | Jaime Stevens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710286489 PECOS PAC ID: 7517271612 Enrollment ID: I20181101000112 |
| Provider Name | Denise S. Duplessis |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1487625083 PECOS PAC ID: 3375577588 Enrollment ID: I20181101002266 |
| Provider Name | Daniel G Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558710947 PECOS PAC ID: 5193079648 Enrollment ID: I20181119003049 |
| Provider Name | Mahamudun Nabi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255624516 PECOS PAC ID: 3870833643 Enrollment ID: I20190314002028 |
| Provider Name | Pauline Wilks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861969966 PECOS PAC ID: 5496088379 Enrollment ID: I20190607001471 |
| Provider Name | Charmaine Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083870265 PECOS PAC ID: 1355572611 Enrollment ID: I20190829000817 |
| Provider Name | Emily Juliana Friedman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265086102 PECOS PAC ID: 0446589931 Enrollment ID: I20190909002517 |
| Provider Name | Justin Marshall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265969042 PECOS PAC ID: 2961732482 Enrollment ID: I20190926001430 |
| Provider Name | Chijioke Nnanna Egbujo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164601548 PECOS PAC ID: 9830484005 Enrollment ID: I20191003000663 |
| Provider Name | Angela Landerholm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639605439 PECOS PAC ID: 6103157201 Enrollment ID: I20191003001750 |
| Provider Name | Anthony Taiwai Ng |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255314621 PECOS PAC ID: 4486720471 Enrollment ID: I20191022003707 |
| Provider Name | Trevor Rishawn Marquis York |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174054456 PECOS PAC ID: 6608112370 Enrollment ID: I20191108001213 |
| Provider Name | Tonya Ruggieri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336676055 PECOS PAC ID: 0840622858 Enrollment ID: I20191113001110 |
| Provider Name | Shanthi Mogali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144406802 PECOS PAC ID: 6406289792 Enrollment ID: I20191126002933 |
| Provider Name | Kathryn Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720084213 PECOS PAC ID: 1850357104 Enrollment ID: I20191206002122 |
| Provider Name | Jane Chamberlain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962472282 PECOS PAC ID: 3678588381 Enrollment ID: I20200108000149 |
| Provider Name | Jules Rosen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497720494 PECOS PAC ID: 0547456626 Enrollment ID: I20200323002184 |
| Provider Name | Carla Schnitzlein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679894679 PECOS PAC ID: 0840414413 Enrollment ID: I20200408001886 |
| Provider Name | Bruce Daniel Bassi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093125759 PECOS PAC ID: 0042515140 Enrollment ID: I20200410000766 |
| Provider Name | Mary Burrous O'malley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649498742 PECOS PAC ID: 2961698238 Enrollment ID: I20200415002216 |
| Provider Name | Gregory Haman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033590773 PECOS PAC ID: 2961702964 Enrollment ID: I20200508001093 |
| Provider Name | Sheeima Paramatmuni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285869271 PECOS PAC ID: 4082942578 Enrollment ID: I20200526001651 |
| Provider Name | Elizabeth Cookson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508866831 PECOS PAC ID: 3072598929 Enrollment ID: I20200527001196 |
| Provider Name | Cassandra Elizabeth Arpin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205461480 PECOS PAC ID: 3274954441 Enrollment ID: I20200527001259 |
| Provider Name | J Carol Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518394196 PECOS PAC ID: 7315264868 Enrollment ID: I20200716000565 |
| Provider Name | Allyson Oshiro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134516057 PECOS PAC ID: 3870808454 Enrollment ID: I20200717001750 |
| Provider Name | Jon Cariker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861915795 PECOS PAC ID: 1951637024 Enrollment ID: I20200728003121 |
| Provider Name | Katherine Sara Reiners |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053710996 PECOS PAC ID: 1153749072 Enrollment ID: I20200909002264 |
| Provider Name | Ignacio Cerdena |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750879722 PECOS PAC ID: 2567713233 Enrollment ID: I20201007001044 |
| Provider Name | Mekessia Richards-carby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033726856 PECOS PAC ID: 1052721685 Enrollment ID: I20201110000644 |
| Provider Name | Shawne L Baker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659705028 PECOS PAC ID: 8022428606 Enrollment ID: I20201110003035 |
| Provider Name | Jeffrey S Gold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245364975 PECOS PAC ID: 5597941294 Enrollment ID: I20201118000266 |
| Provider Name | Stanley Hospod |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457663841 PECOS PAC ID: 2567873649 Enrollment ID: I20201120001207 |
| Provider Name | Michael Mei |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700373883 PECOS PAC ID: 8729337217 Enrollment ID: I20201202002882 |
| Provider Name | Katie Feeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033693213 PECOS PAC ID: 7810241411 Enrollment ID: I20201210000713 |
| Provider Name | Michael Connolly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003303181 PECOS PAC ID: 3173872546 Enrollment ID: I20210107001855 |
| Provider Name | Othman M Mohammad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912138660 PECOS PAC ID: 8729301825 Enrollment ID: I20210311001652 |
| Provider Name | Kerri Sisson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942583141 PECOS PAC ID: 0244647725 Enrollment ID: I20210330000239 |
| Provider Name | Manuel B Montes De Oca |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871624353 PECOS PAC ID: 3779524327 Enrollment ID: I20210408000751 |
| Provider Name | Melanie Nicole Duranti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861727901 PECOS PAC ID: 9133537004 Enrollment ID: I20210413002089 |
| Provider Name | Danilo A. Rojas-velasquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578094173 PECOS PAC ID: 4688947724 Enrollment ID: I20210421002767 |
| Provider Name | Madison Mcnally Dahm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700407905 PECOS PAC ID: 3779991245 Enrollment ID: I20210421002951 |
| Provider Name | Mukesh Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992966188 PECOS PAC ID: 9133396385 Enrollment ID: I20210517002425 |
| Provider Name | Ayotunde Ayobello |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700317575 PECOS PAC ID: 5294008835 Enrollment ID: I20210518000971 |
| Provider Name | Sharon Stecher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518142116 PECOS PAC ID: 8325950025 Enrollment ID: I20210520000081 |
| Provider Name | Benjamin Jacobi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508328931 PECOS PAC ID: 3870823990 Enrollment ID: I20210526001782 |
| Provider Name | Michael Mcclurkin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902366768 PECOS PAC ID: 5092040188 Enrollment ID: I20210723002476 |
| Provider Name | Julia Mary Cizeski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629642897 PECOS PAC ID: 3375947039 Enrollment ID: I20210803003151 |
| Provider Name | Syeda I Hasan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447370259 PECOS PAC ID: 7012079858 Enrollment ID: I20210817003828 |
| Provider Name | Marie Joassaint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366895799 PECOS PAC ID: 3971936121 Enrollment ID: I20210908000238 |
| Provider Name | Ashley Susje Sanchez Ramos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922599372 PECOS PAC ID: 1759787906 Enrollment ID: I20210914000186 |
| Provider Name | Amanda Calhoun |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992360903 PECOS PAC ID: 2466780853 Enrollment ID: I20210920000161 |
| Provider Name | Nickesha Mckenzie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881223394 PECOS PAC ID: 8325469026 Enrollment ID: I20211022001495 |
| Provider Name | Ashley Perreira |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689295883 PECOS PAC ID: 7517357056 Enrollment ID: I20211124000766 |
| Provider Name | John Creegan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356872659 PECOS PAC ID: 3577835776 Enrollment ID: I20211208001960 |
| Provider Name | Erin Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780991117 PECOS PAC ID: 2466876636 Enrollment ID: I20211222002162 |
| Provider Name | Edward Kuhnley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366443434 PECOS PAC ID: 2668494972 Enrollment ID: I20211228002412 |
| Provider Name | Sarah Casey Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144428970 PECOS PAC ID: 4789076217 Enrollment ID: I20220113001317 |
| Provider Name | Heather Marie Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356000863 PECOS PAC ID: 7618364837 Enrollment ID: I20220418001759 |
| Provider Name | Matthew Robbins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316443450 PECOS PAC ID: 9234488941 Enrollment ID: I20220427000416 |
| Provider Name | Janet Elisabeth Sykes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710544580 PECOS PAC ID: 7416382825 Enrollment ID: I20220602001386 |
| Provider Name | Victoria Akpan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750052817 PECOS PAC ID: 4082929500 Enrollment ID: I20220607002384 |
| Provider Name | Sheila Wilkey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174833834 PECOS PAC ID: 6608045216 Enrollment ID: I20220613002548 |
| Provider Name | Ronald E Weir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225657521 PECOS PAC ID: 5092198614 Enrollment ID: I20220815002899 |
| Provider Name | Silvia Fernandez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740447358 PECOS PAC ID: 4486726445 Enrollment ID: I20220815003444 |
| Provider Name | Barbara Trejo Ortega |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467089326 PECOS PAC ID: 2365830569 Enrollment ID: I20220921000824 |
| Provider Name | Irina Chernyshkova |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891358255 PECOS PAC ID: 1355718974 Enrollment ID: I20221110000425 |
| Provider Name | Vanessa Green |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093036378 PECOS PAC ID: 6406140714 Enrollment ID: I20221115002938 |
| Provider Name | Haruna Asafotei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669080933 PECOS PAC ID: 9032523964 Enrollment ID: I20221206000435 |
| Provider Name | Alanna Kavanaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912448937 PECOS PAC ID: 8820367717 Enrollment ID: I20230217000567 |
| Provider Name | Lisa Curtain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245795491 PECOS PAC ID: 5597006080 Enrollment ID: I20230314002299 |
| Provider Name | Stephanie Kay Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730888595 PECOS PAC ID: 2769856202 Enrollment ID: I20230323000917 |
| Provider Name | Manu Dhawan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174146575 PECOS PAC ID: 6608231238 Enrollment ID: I20230503001575 |
| Provider Name | Clarence D Case |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134735723 PECOS PAC ID: 9638572241 Enrollment ID: I20230509000431 |
| Provider Name | Andrew Sheldon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306400858 PECOS PAC ID: 8022342625 Enrollment ID: I20230619000367 |
| Provider Name | Jose R Perez Martell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821653247 PECOS PAC ID: 3971838574 Enrollment ID: I20230712001969 |
| Provider Name | Sabih Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760035539 PECOS PAC ID: 1951761048 Enrollment ID: I20230720003624 |
| Provider Name | Sunil Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316559347 PECOS PAC ID: 1153783691 Enrollment ID: I20230815001795 |
| Provider Name | Anup Ojha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235741596 PECOS PAC ID: 2163884438 Enrollment ID: I20230817003853 |
| Provider Name | Miranda Claire Rogers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528645280 PECOS PAC ID: 4082068820 Enrollment ID: I20230927001237 |
| Provider Name | Daniel Flack |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184305534 PECOS PAC ID: 1658725361 Enrollment ID: I20230929000499 |
| Provider Name | Virginia Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104308204 PECOS PAC ID: 7113258070 Enrollment ID: I20231017000704 |
| Provider Name | Shae Ian Rowlandson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285211219 PECOS PAC ID: 9133575673 Enrollment ID: I20231019002851 |
| Provider Name | Adam Nicholas Kolb |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700463866 PECOS PAC ID: 8325494503 Enrollment ID: I20231024002585 |
| Provider Name | Dylan Ross Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548948912 PECOS PAC ID: 6305292582 Enrollment ID: I20231024002686 |
| Provider Name | Daniel S Caredeo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386228047 PECOS PAC ID: 3173979184 Enrollment ID: I20231027001007 |
| Provider Name | Yadira Oliva Castillo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275117335 PECOS PAC ID: 3971950213 Enrollment ID: I20231108002724 |
| Provider Name | Matthew Carriero Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255835245 PECOS PAC ID: 2466809652 Enrollment ID: I20231109001261 |
| Provider Name | Janet Adeola Korede Keku |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215514757 PECOS PAC ID: 4688074446 Enrollment ID: I20231117000212 |
| Provider Name | Kia Weinreber Sayers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669050811 PECOS PAC ID: 0547660177 Enrollment ID: I20231120003045 |
| Provider Name | Joseph Buck Jabaily |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902472566 PECOS PAC ID: 3870995152 Enrollment ID: I20231128000067 |
| Provider Name | Michael Osullivan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043887300 PECOS PAC ID: 2264835636 Enrollment ID: I20231206002096 |
| Provider Name | Kaosoluchi Enendu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184204695 PECOS PAC ID: 5092104802 Enrollment ID: I20231207000827 |
| Provider Name | Kayla Harrington Isaacs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225657216 PECOS PAC ID: 6901255322 Enrollment ID: I20231211003340 |
| Provider Name | Nora H. Abdullah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295354298 PECOS PAC ID: 1254780331 Enrollment ID: I20231214002262 |
| Provider Name | Natalie Ann Porter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861462780 PECOS PAC ID: 4486005493 Enrollment ID: I20240103004257 |
| Provider Name | Diane Tarricone |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942332168 PECOS PAC ID: 9234582107 Enrollment ID: I20240126001624 |
| Provider Name | Hannah Marie Trudo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326785874 PECOS PAC ID: 5799129896 Enrollment ID: I20240216002014 |
| Provider Name | Gracie Vanessa Alleyne-popo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780145409 PECOS PAC ID: 6103262670 Enrollment ID: I20240307001356 |
| Provider Name | Eduardo Meza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487729422 PECOS PAC ID: 3072505361 Enrollment ID: I20240417004146 |
| Provider Name | Talia Stewart |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851928436 PECOS PAC ID: 2860813524 Enrollment ID: I20240521000774 |
| Provider Name | Shaan Kamal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811567852 PECOS PAC ID: 8224470232 Enrollment ID: I20240522002363 |
| Provider Name | Oluwaseyi Adeyinka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215513106 PECOS PAC ID: 9638579386 Enrollment ID: I20240610000389 |
| Provider Name | Blenda Deloris Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730330952 PECOS PAC ID: 6305388919 Enrollment ID: I20240611003063 |
| Provider Name | Arshpreet Gulati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023570082 PECOS PAC ID: 5698004927 Enrollment ID: I20240626001867 |
| Provider Name | Megan Haaga |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497123681 PECOS PAC ID: 2961946041 Enrollment ID: I20240701000262 |
| Provider Name | Leah Russack-baker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073822789 PECOS PAC ID: 9234673898 Enrollment ID: I20240708000695 |
| Provider Name | Luke B O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366062861 PECOS PAC ID: 2365989712 Enrollment ID: I20240802000535 |
| Provider Name | Farah Desrosiers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497104178 PECOS PAC ID: 2668768656 Enrollment ID: I20240820003095 |
| Provider Name | Caylan Juwon Bookman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922744697 PECOS PAC ID: 4284170630 Enrollment ID: I20241024000742 |
| Provider Name | Jessica Persad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336907641 PECOS PAC ID: 8022541473 Enrollment ID: I20241024000838 |
| Provider Name | Pamela Marie Lavigna |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831347350 PECOS PAC ID: 3072046895 Enrollment ID: I20241031000947 |
| Provider Name | Ataollah Rajabnejad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477173995 PECOS PAC ID: 9436682242 Enrollment ID: I20241101000186 |
| Provider Name | Stephanie Backer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881116796 PECOS PAC ID: 3971836586 Enrollment ID: I20241107000794 |
| Provider Name | Tabraiz Rasul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649878604 PECOS PAC ID: 9032520929 Enrollment ID: I20241111002319 |
| Provider Name | Judy N Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912640814 PECOS PAC ID: 6608300777 Enrollment ID: I20241112002112 |
| Provider Name | Sherrie Sharp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083639447 PECOS PAC ID: 5890703987 Enrollment ID: I20241125001608 |
| Provider Name | Sarah D Abbott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164279691 PECOS PAC ID: 3072042456 Enrollment ID: I20250130000880 |
| Provider Name | Sheri Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093063364 PECOS PAC ID: 1557806908 Enrollment ID: I20250203000029 |
| Provider Name | Daniel Spencer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164650321 PECOS PAC ID: 5597983205 Enrollment ID: I20250204003078 |
| Provider Name | Lynne Cappellucci |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952407744 PECOS PAC ID: 0143226407 Enrollment ID: I20250218002748 |
| Provider Name | Jay Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629047642 PECOS PAC ID: 0648354399 Enrollment ID: I20250320003843 |
| Provider Name | Meghan Vandewettering |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689323545 PECOS PAC ID: 8325417249 Enrollment ID: I20250424003410 |
| Provider Name | Sarah Yang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013558345 PECOS PAC ID: 3476070681 Enrollment ID: I20250509002428 |
| Provider Name | Joshua Sabel |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093169856 PECOS PAC ID: 8224557384 Enrollment ID: I20250522000418 |
Mary Kinsella-shaw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 31 Warrenville Rd, Mansfield Center, CT 06250 Phone: 860-450-1173 | |
Ann M. Pacheco Lmft, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2 Mansfield Hollow Rd, Mansfield Center, CT 06250 Phone: 860-423-0877 | |
Tamara Vertefeuille, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 Storrs Rd, Mansfield Center, CT 06250 Phone: 860-456-4604 Fax: 860-450-1310 | |
Mount Hope Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Warrenville Rd, Mansfield Center, CT 06250 Phone: 860-429-2463 | |
Danielle N. Christian, Lcsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18 Ledgebrook Dr, Suite E-3, Mansfield Center, CT 06250 Phone: 860-428-0403 | |
Mark Schroeder Md, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 354 Warrenville Rd, Mansfield Center, CT 06250 Phone: 860-455-9879 |