| Peaceful Mind Behavioral Health & Wellness, Llc | |
|
123 Middle Street Bristol CT 06010-7404 | |
| (860) 281-2280 | |
| (860) 499-3514 |
| Full Name | Peaceful Mind Behavioral Health & Wellness, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 123 Middle Street, Bristol, Connecticut |
| Authorized Official Name and Position | Morgan Poeta (OWNER/LPC) |
| Authorized Official Contact | 8602812280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peaceful Mind Behavioral Health & Wellness, Llc 123 Middle Street Bristol CT 06010-7404 Ph: (860) 281-2280 | Peaceful Mind Behavioral Health & Wellness, Llc 123 Middle Street Bristol CT 06010-7404 Ph: (860) 281-2280 |
| NPI Number | 1255926358 |
|---|---|
| Provider Enumeration Date | 03/02/2021 |
| Last Update Date | 06/29/2022 |
| Certification Date | 06/29/2022 |
| Medicare PECOS PAC ID | 0941683056 |
|---|---|
| Medicare Enrollment ID | O20220822002310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255926358 | NPI | - | NPPES |
| Provider Name | Melinda J Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295925485 PECOS PAC ID: 7618063710 Enrollment ID: I20071022000160 |
| Provider Name | Melissa M Masse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851625271 PECOS PAC ID: 5496880312 Enrollment ID: I20100317000807 |
| Provider Name | Suzanne A Rosenberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003130519 PECOS PAC ID: 2567766033 Enrollment ID: I20160203000725 |
| Provider Name | Lora Small |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437554730 PECOS PAC ID: 9830470376 Enrollment ID: I20161221001557 |
| Provider Name | Eni V Smith |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1659786275 PECOS PAC ID: 6002033438 Enrollment ID: I20190115003201 |
| Provider Name | Olivia Ann Goforth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871009563 PECOS PAC ID: 4981934734 Enrollment ID: I20190923000832 |
| Provider Name | Niccole Lambert-talhaoui |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578113858 PECOS PAC ID: 5890127039 Enrollment ID: I20201109002255 |
| Provider Name | Jeong Mi Pak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174097331 PECOS PAC ID: 2668801168 Enrollment ID: I20201201000118 |
| Provider Name | Amanda Dill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962811240 PECOS PAC ID: 3577978279 Enrollment ID: I20210210001284 |
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