| Supportive Solutions Behavioral Health And Wellness Llc | |
|
2911 Dixwell Ave Ste 302 Hamden CT 06518-3130 | |
| (203) 376-0220 | |
| Not Available |
| Full Name | Supportive Solutions Behavioral Health And Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2911 Dixwell Ave Ste 302, Hamden, Connecticut |
| Authorized Official Name and Position | Shalyn Rose (OWNER/LCSW) |
| Authorized Official Contact | 2033760220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Solutions Behavioral Health And Wellness Llc 49 Englewood Dr New Haven CT 06515-2309 Ph: () - | Supportive Solutions Behavioral Health And Wellness Llc 2911 Dixwell Ave Ste 302 Hamden CT 06518-3130 Ph: (203) 376-0220 |
| NPI Number | 1598260226 |
|---|---|
| Provider Enumeration Date | 03/26/2018 |
| Last Update Date | 03/26/2018 |
| Medicare PECOS PAC ID | 6901151067 |
|---|---|
| Medicare Enrollment ID | O20180614001170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598260226 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Linda S Mittenthal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487670014 PECOS PAC ID: 3476556549 Enrollment ID: I20060809000393 |
| Provider Name | Rhianon N Iassogna Roman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457422057 PECOS PAC ID: 1456351022 Enrollment ID: I20070104000214 |
| Provider Name | Shalyn Rose |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952650897 PECOS PAC ID: 8921315847 Enrollment ID: I20150909002521 |
| Provider Name | Katie Lynn Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295118081 PECOS PAC ID: 5991050130 Enrollment ID: I20180612002282 |
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