| Behavioral Wellness Partners, Llc | |
|
25 Davenport Farm Ln E Stamford CT 06903-5141 | |
| (203) 687-0464 | |
| Not Available |
| Full Name | Behavioral Wellness Partners, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 25 Davenport Farm Ln E, Stamford, Connecticut |
| Authorized Official Name and Position | Carissa Tufano (APRN) |
| Authorized Official Contact | 2036870464 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Wellness Partners, Llc Po Box 665 Stamford CT 06904 Ph: () - | Behavioral Wellness Partners, Llc 25 Davenport Farm Ln E Stamford CT 06903-5141 Ph: (203) 687-0464 |
| NPI Number | 1245848670 |
|---|---|
| Provider Enumeration Date | 07/22/2020 |
| Last Update Date | 06/15/2022 |
| Certification Date | 06/15/2022 |
| Medicare PECOS PAC ID | 9830504570 |
|---|---|
| Medicare Enrollment ID | O20210210002863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245848670 | NPI | - | NPPES |
| 1255382396 | Other | CT | GROUP NPI |
| 1245848670 | Other | CT | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jay K Berkowitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255382396 PECOS PAC ID: 4688622319 Enrollment ID: I20050110000231 |
| Provider Name | Carissa A Tufano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760639819 PECOS PAC ID: 1850452087 Enrollment ID: I20081206000101 |
| Provider Name | Maryfrances L Desteno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922374354 PECOS PAC ID: 9436308087 Enrollment ID: I20120926000125 |
| Provider Name | Jaclyn M Vitkovsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508472259 PECOS PAC ID: 9931512399 Enrollment ID: I20210105000609 |
| Provider Name | Nicole Katherine Mcenerney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972264158 PECOS PAC ID: 4486035243 Enrollment ID: I20220726000239 |
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