Marisa L Valdiserra, MA | |
255 Hempstead St, New London, CT 06320-6204 | |
(860) 443-2896 | |
(860) 442-5909 |
Full Name | Marisa L Valdiserra |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 255 Hempstead St, New London, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598001380 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2721 (Connecticut) | Primary |
Entity Name | Mind Body Counseling Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578029377 PECOS PAC ID: 6204276637 Enrollment ID: O20240501003455 |
Mailing Address | Practice Location Address |
---|---|
Marisa L Valdiserra, MA 31 Laurel Grove Dr, Higganum, CT 06441-4355 Ph: (860) 227-1369 | Marisa L Valdiserra, MA 255 Hempstead St, New London, CT 06320-6204 Ph: (860) 443-2896 |
Nichole Burns, Counselor Medicare: Medicare Enrolled Practice Location: 21 Montauk Avene, New London, CT 06320 Phone: 860-271-4715 Fax: 860-271-4797 | |
Theresa M. Bonanomi, Counselor Medicare: Accepting Medicare Assignments Practice Location: 365 Montauk Ave, New London, CT 06320 Phone: 860-444-5141 | |
Bethany Gallant, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 21 Montauk Ave, New London, CT 06320 Phone: 860-443-0530 Fax: 860-443-0536 | |
Lindsay Warner, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Vauxhall St, New London, CT 06320 Phone: 860-437-4550 Fax: 860-661-4262 | |
Marie Salvemini, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 Shaws Cv, New London, CT 06320 Phone: 860-447-8304 Fax: 860-443-8720 | |
Katherine Cichon, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 300 State St, Suite 307, New London, CT 06320 Phone: 860-941-9380 | |
Madilynn Jane Delach, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 7 Vauxhall St, New London, CT 06320 Phone: 860-437-4550 |