| River Rock Psychiatry, Llc | |
|
545 Main St Middlefield CT 06455-1293 | |
| (860) 918-4182 | |
| Not Available |
| Full Name | River Rock Psychiatry, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 545 Main St, Middlefield, Connecticut |
| Authorized Official Name and Position | Susan Mcnamara (MEMBER) |
| Authorized Official Contact | 8609184182 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Rock Psychiatry, Llc 545 Main St Middlefield CT 06455-1293 Ph: (860) 918-4182 | River Rock Psychiatry, Llc 545 Main St Middlefield CT 06455-1293 Ph: (860) 918-4182 |
| NPI Number | 1124405709 |
|---|---|
| Provider Enumeration Date | 05/02/2015 |
| Last Update Date | 04/01/2022 |
| Certification Date | 04/01/2022 |
| Medicare PECOS PAC ID | 1254647043 |
|---|---|
| Medicare Enrollment ID | O20150824001604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124405709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Susan Mcnamara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063432466 PECOS PAC ID: 4082624150 Enrollment ID: I20060503000734 |
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