| Optum Behavioral Care Of Connecticut, P.c. | |
|
415 Boston Post Rd Milford CT 06460-2578 | |
| (203) 819-0789 | |
| Not Available |
| Full Name | Optum Behavioral Care Of Connecticut, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 415 Boston Post Rd, Milford, Connecticut |
| Authorized Official Name and Position | Amanda Bronson (CEO) |
| Authorized Official Contact | 7045066267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum Behavioral Care Of Connecticut, P.c. 67 Burnside Ave East Hartford CT 06108-3408 Ph: (952) 246-4564 | Optum Behavioral Care Of Connecticut, P.c. 415 Boston Post Rd Milford CT 06460-2578 Ph: (203) 819-0789 |
| NPI Number | 1164203238 |
|---|---|
| Provider Enumeration Date | 10/13/2023 |
| Last Update Date | 12/06/2023 |
| Certification Date | 12/06/2023 |
| Medicare PECOS PAC ID | 9436502879 |
|---|---|
| Medicare Enrollment ID | O20240201001054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164203238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Jessica M Screen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609116029 PECOS PAC ID: 2062650856 Enrollment ID: I20130606000567 |
| Provider Name | Jaclyn Elizabeth Alessio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902458359 PECOS PAC ID: 1850622762 Enrollment ID: I20191008000779 |
| Provider Name | Hairong Wang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154952794 PECOS PAC ID: 7810318664 Enrollment ID: I20200602002468 |
| Provider Name | Marie Goodine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023642998 PECOS PAC ID: 1355755240 Enrollment ID: I20210204002679 |
| Provider Name | Desiree Nicole Emirzian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669948428 PECOS PAC ID: 5395151807 Enrollment ID: I20210309000125 |
| Provider Name | Rachael Elizabeth Burke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588937114 PECOS PAC ID: 5799191144 Enrollment ID: I20210309002139 |
| Provider Name | Rio Elena Comaduran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477065043 PECOS PAC ID: 2769881309 Enrollment ID: I20210601002432 |
| Provider Name | Dana Segall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982149480 PECOS PAC ID: 1355742156 Enrollment ID: I20210630003836 |
| Provider Name | Cathleen Nowak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346712031 PECOS PAC ID: 8325446263 Enrollment ID: I20211007001769 |
| Provider Name | Alexis Loren Greenwood |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700506680 PECOS PAC ID: 0941685150 Enrollment ID: I20220923000403 |
| Provider Name | Kristal Alexis Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295380913 PECOS PAC ID: 3274904560 Enrollment ID: I20230124003231 |
| Provider Name | Kelly Tarascio |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174112262 PECOS PAC ID: 9234500554 Enrollment ID: I20230125000858 |
| Provider Name | Carly Rae Jacques |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467022830 PECOS PAC ID: 9739551086 Enrollment ID: I20230214001757 |
| Provider Name | Paulette Atse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861112013 PECOS PAC ID: 7719350917 Enrollment ID: I20230309002000 |
| Provider Name | Christina Kalogeris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811542715 PECOS PAC ID: 7517332703 Enrollment ID: I20230330002028 |
| Provider Name | Karissa Piedescalzo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932556602 PECOS PAC ID: 8628442894 Enrollment ID: I20230407000440 |
| Provider Name | Brittany Muldowney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114647922 PECOS PAC ID: 8325403744 Enrollment ID: I20230508000984 |
| Provider Name | Michele Granville Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902388234 PECOS PAC ID: 4183083983 Enrollment ID: I20230711001546 |
| Provider Name | Joseph John Jacovino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710422068 PECOS PAC ID: 8426417262 Enrollment ID: I20230711002762 |
| Provider Name | Taurus Lazine Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063868982 PECOS PAC ID: 8729449194 Enrollment ID: I20230801003391 |
| Provider Name | Alyssa Ashly Kondor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164991451 PECOS PAC ID: 1557723640 Enrollment ID: I20230822002407 |
| Provider Name | Kerin B Foley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154337004 PECOS PAC ID: 4981068095 Enrollment ID: I20230907003281 |
| Provider Name | Timothy John Rowe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073173035 PECOS PAC ID: 1153775648 Enrollment ID: I20231003000781 |
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