| Waterside Behavioral Health, Llc | |
|
130 Montowese St Branford CT 06405-3841 | |
| (203) 535-5522 | |
| (812) 759-9869 |
| Full Name | Waterside Behavioral Health, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 130 Montowese St, Branford, Connecticut |
| Authorized Official Name and Position | Barbara L Greenspan (OWNER) |
| Authorized Official Contact | 2035355522 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterside Behavioral Health, Llc Po Box 385 Madison CT 06443-0385 Ph: (812) 853-9110 | Waterside Behavioral Health, Llc 130 Montowese St Branford CT 06405-3841 Ph: (203) 535-5522 |
| NPI Number | 1275079394 |
|---|---|
| Provider Enumeration Date | 01/12/2017 |
| Last Update Date | 01/12/2017 |
| Medicare PECOS PAC ID | 3577847318 |
|---|---|
| Medicare Enrollment ID | O20170223000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275079394 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Barbara Greenspan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548544869 PECOS PAC ID: 9234302076 Enrollment ID: I20111024000328 |
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