| Advanced Telepsych Pllc | |
|
760 Saybrook Rd Ste 2 Middletown CT 06457-4785 | |
| (888) 344-3893 | |
| Not Available |
| Full Name | Advanced Telepsych Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 760 Saybrook Rd Ste 2, Middletown, Connecticut |
| Authorized Official Name and Position | Lee Anne Langhurst (COO) |
| Authorized Official Contact | 4124017484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Telepsych Pllc 760 Saybrook Rd Ste 2 Middletown CT 06457-4785 Ph: (888) 344-3893 | Advanced Telepsych Pllc 760 Saybrook Rd Ste 2 Middletown CT 06457-4785 Ph: (888) 344-3893 |
| NPI Number | 1508456377 |
|---|---|
| Provider Enumeration Date | 01/25/2021 |
| Last Update Date | 06/16/2023 |
| Certification Date | 06/16/2023 |
| Medicare PECOS PAC ID | 6800275603 |
|---|---|
| Medicare Enrollment ID | O20230106001717 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508456377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Sandra J. Rabis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902998263 PECOS PAC ID: 4082690995 Enrollment ID: I20040629001204 |
| Provider Name | Emily Peluso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598730095 PECOS PAC ID: 9739159260 Enrollment ID: I20040730000340 |
| Provider Name | Kate Leblanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417349754 PECOS PAC ID: 2567783848 Enrollment ID: I20150611002938 |
| Provider Name | Julia A Frankel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023543725 PECOS PAC ID: 5991065658 Enrollment ID: I20180129001991 |
| Provider Name | Stephanie Larose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235647181 PECOS PAC ID: 4385905876 Enrollment ID: I20180226000081 |
| Provider Name | Ashley C Labonte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770074957 PECOS PAC ID: 6204180912 Enrollment ID: I20181115002838 |
| Provider Name | Amber A Morrone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699292458 PECOS PAC ID: 9032459094 Enrollment ID: I20190329000385 |
| Provider Name | Perry Githens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811498611 PECOS PAC ID: 5698037232 Enrollment ID: I20200710001404 |
| Provider Name | Maegan Monterose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376293316 PECOS PAC ID: 2769878198 Enrollment ID: I20220411002187 |
| Provider Name | Dedra Terry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184089369 PECOS PAC ID: 3476842444 Enrollment ID: I20220518000557 |
| Provider Name | Naomi Mputu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821368713 PECOS PAC ID: 0345694311 Enrollment ID: I20230925001642 |
| Provider Name | Diana Lankenau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598244667 PECOS PAC ID: 0244644078 Enrollment ID: I20231128003508 |
| Provider Name | Arthur Edward Brouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598308876 PECOS PAC ID: 0143603597 Enrollment ID: I20231206000164 |
| Provider Name | Melissa Miller Gad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295773497 PECOS PAC ID: 0941212237 Enrollment ID: I20240102002113 |
| Provider Name | Lisa Renee' Ford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427282953 PECOS PAC ID: 5890130546 Enrollment ID: I20240304002628 |
| Provider Name | Nathan Tyson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497536882 PECOS PAC ID: 4284071267 Enrollment ID: I20240326003001 |
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