| Catholic Charities Inc - Archdiocese Of Hartford | |
|
56 Church St Waterbury CT 06702-2103 | |
| (203) 755-1196 | |
| (203) 575-9675 |
| Full Name | Catholic Charities Inc - Archdiocese Of Hartford |
|---|---|
| Speciality | Clinic/Center |
| Location | 56 Church St, Waterbury, Connecticut |
| Authorized Official Name and Position | Rose Alma Senatore (CEO) |
| Authorized Official Contact | 8604931841 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catholic Charities Inc - Archdiocese Of Hartford 839 Asylum Ave Hartford CT 06105-2801 Ph: (860) 493-1841 | Catholic Charities Inc - Archdiocese Of Hartford 56 Church St Waterbury CT 06702-2103 Ph: (203) 755-1196 |
| NPI Number | 1154415354 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 04/21/2010 |
| Medicare PECOS PAC ID | 2567367469 |
|---|---|
| Medicare Enrollment ID | O20031204000429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154415354 | NPI | - | NPPES |
| B000672 | Other | CT | CTGA |
| ANC1423 | Other | CT | OXFORD |
| 77ABH0006CT08 | Other | CO | BC/BS |
| 183459 | Other | CO | HEALTH NET/MHN |
| 004040713 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Catherine F Lewis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275539488 PECOS PAC ID: 3779579669 Enrollment ID: I20040424000362 |
| Provider Name | Gina Higgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114110160 PECOS PAC ID: 3577656503 Enrollment ID: I20070907000404 |
| Provider Name | Mary Ann Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578794053 PECOS PAC ID: 3476681461 Enrollment ID: I20100512000766 |
| Provider Name | Lisa C Diamond |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184710550 PECOS PAC ID: 6800924663 Enrollment ID: I20100514000692 |
| Provider Name | Monica Ann Starr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770868085 PECOS PAC ID: 5698906022 Enrollment ID: I20140815001393 |
| Provider Name | Tanya Ruth Bassett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801293824 PECOS PAC ID: 2961725031 Enrollment ID: I20141222000071 |
| Provider Name | Martell M Hawkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982142808 PECOS PAC ID: 1254746027 Enrollment ID: I20210209002736 |
| Provider Name | Maria D Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821575929 PECOS PAC ID: 6204239031 Enrollment ID: I20210730001178 |
| Provider Name | Sherly Boulay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851766737 PECOS PAC ID: 0547648180 Enrollment ID: I20220609001887 |
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