Connecticut Behavioral Health Assoc, P.c. | |
41 Fair Harbour Pl New London CT 06320-4710 | |
(860) 437-6914 | |
(860) 437-6920 |
Full Name | Connecticut Behavioral Health Assoc, P.c. |
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Speciality | Clinic/Center |
Location | 41 Fair Harbour Pl, New London, Connecticut |
Authorized Official Name and Position | Bassam Awwa (MEDICAL DIRECTOR) |
Authorized Official Contact | 8604376914 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Connecticut Behavioral Health Assoc, P.c. 41 Fair Harbour Pl New London CT 06320-4710 Ph: (860) 437-6914 | Connecticut Behavioral Health Assoc, P.c. 41 Fair Harbour Pl New London CT 06320-4710 Ph: (860) 437-6914 |
NPI Number | 1629158126 |
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Provider Enumeration Date | 10/17/2006 |
Last Update Date | 11/16/2015 |
Medicare PECOS PAC ID | 4385532373 |
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Medicare Enrollment ID | O20040310000567 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629158126 | NPI | - | NPPES |
004192324 | Medicaid | CT | |
004255388 | Medicaid | CT | |
008008065 | Medicaid | CT | |
004199271 | Medicaid | CT | |
004255411 | Medicaid | CT | |
004195774 | Medicaid | CT |
Provider Name | Nancy G Miner |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1487772943 PECOS PAC ID: 7911994397 Enrollment ID: I20040428000167 |
Provider Name | Ammar Traboulsi |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1225125610 PECOS PAC ID: 1355308495 Enrollment ID: I20041210000241 |
Provider Name | Donna G Shinn |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1932113354 PECOS PAC ID: 8820020324 Enrollment ID: I20050906000763 |
Provider Name | Renata K Kozak |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1730124579 PECOS PAC ID: 7416962667 Enrollment ID: I20060209000462 |
Provider Name | Maryanne Campbell |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1457453110 PECOS PAC ID: 6800990334 Enrollment ID: I20070322000428 |
Provider Name | Gina Higgins |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114110160 PECOS PAC ID: 3577656503 Enrollment ID: I20070907000404 |
Provider Name | Stephanie R Langlais |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1043334923 PECOS PAC ID: 8527116292 Enrollment ID: I20090507000177 |
Provider Name | Lorraine Welcome |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114003944 PECOS PAC ID: 8022168756 Enrollment ID: I20090618000079 |
Provider Name | Ann D Sawyer |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1336381771 PECOS PAC ID: 4688729536 Enrollment ID: I20090828000548 |
Provider Name | Bassam Awwa |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1881774354 PECOS PAC ID: 5193613198 Enrollment ID: I20091028000687 |
Provider Name | Toni C Perry |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1427110345 PECOS PAC ID: 6002945433 Enrollment ID: I20100524000741 |
Provider Name | Maturin F Waldo |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1629178348 PECOS PAC ID: 9436250404 Enrollment ID: I20100823000271 |
Provider Name | Robin M Hennessey |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1629395652 PECOS PAC ID: 7719173962 Enrollment ID: I20101130000514 |
Provider Name | Paula Mekkelsen |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1710076419 PECOS PAC ID: 0446448997 Enrollment ID: I20101228000060 |
Provider Name | Steven Simonson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164519591 PECOS PAC ID: 4385832831 Enrollment ID: I20101228000152 |
Provider Name | Joan Pavlinsky |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1386721983 PECOS PAC ID: 2163602046 Enrollment ID: I20110209000935 |
Provider Name | Amanda Speicher |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1376843011 PECOS PAC ID: 4183695844 Enrollment ID: I20110314000590 |
Provider Name | Diaa Noaman |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1417143603 PECOS PAC ID: 9830367556 Enrollment ID: I20110725000694 |
Provider Name | Rose Marie Zmyslinski |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1750460770 PECOS PAC ID: 4385818533 Enrollment ID: I20111128000168 |
Provider Name | Audrey A Allen |
---|---|
Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
Provider Identifiers | NPI Number: 1710232947 PECOS PAC ID: 6204072432 Enrollment ID: I20130413000101 |
Provider Name | Ralph Hirschfeld |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1144523077 PECOS PAC ID: 1658693742 Enrollment ID: I20141126001513 |
Provider Name | Erin M Corbett |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1548490758 PECOS PAC ID: 6204158926 Enrollment ID: I20141209001210 |
Provider Name | Kate Leblanc |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417349754 PECOS PAC ID: 2567783848 Enrollment ID: I20150611002938 |
Provider Name | Harold E Fischer |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1427071018 PECOS PAC ID: 1355649245 Enrollment ID: I20160408001095 |
Provider Name | Edwin G. Taetsch |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164445581 PECOS PAC ID: 5193786291 Enrollment ID: I20160719002133 |
Provider Name | Chinwendu Jennifer Chukwudike |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982176020 PECOS PAC ID: 0840531182 Enrollment ID: I20190415000365 |
Provider Name | Paul Cancro |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1538388541 PECOS PAC ID: 9436488558 Enrollment ID: I20190913002240 |
Provider Name | Debra Lee Sicilian |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386101798 PECOS PAC ID: 9638400799 Enrollment ID: I20191004000406 |
Provider Name | Stanley Hospod |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1457663841 PECOS PAC ID: 2567873649 Enrollment ID: I20201120001207 |
Provider Name | Ruby Mensah |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679214555 PECOS PAC ID: 8224418041 Enrollment ID: I20220711000360 |
Provider Name | Hui Hu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548986276 PECOS PAC ID: 6103296751 Enrollment ID: I20221223000864 |
Provider Name | Kristen Fernandez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881301711 PECOS PAC ID: 1153787239 Enrollment ID: I20230516000144 |
Provider Name | Natalie Ann Porter |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1861462780 PECOS PAC ID: 4486005493 Enrollment ID: I20240103004257 |
Provider Name | Nadeije Rita Ahearn |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1811203441 PECOS PAC ID: 6709238611 Enrollment ID: I20240116004100 |
Provider Name | Lisa Marie Tonnessen |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1083713119 PECOS PAC ID: 0345692703 Enrollment ID: I20240122001841 |
Provider Name | James Longo |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1164644126 PECOS PAC ID: 1456490002 Enrollment ID: I20240122002592 |
Provider Name | Margaret Klinger |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1386864056 PECOS PAC ID: 9436501780 Enrollment ID: I20240123000574 |
Provider Name | Lauren Mary Franza |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467179028 PECOS PAC ID: 3971956012 Enrollment ID: I20240125001413 |
Provider Name | John F Sidoli |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1548330319 PECOS PAC ID: 6608210075 Enrollment ID: I20240214001375 |
Provider Name | Stephanie Gill-manville |
---|---|
Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1376795112 PECOS PAC ID: 1951745082 Enrollment ID: I20240216002456 |
Provider Name | Judith G Williams |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1821200924 PECOS PAC ID: 2163867557 Enrollment ID: I20240226000446 |
Provider Name | Judith L. Farrington |
---|---|
Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1205936390 PECOS PAC ID: 1557708252 Enrollment ID: I20240318000833 |
Connecticut Behavioral Health Assoc. P.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 41 Fair Harbour Pl, New London, CT 06320 Phone: 860-437-6910 Fax: 860-437-6920 | |
Cultivate & Grow Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 State St Suite 307, New London, CT 06320 Phone: 860-639-7728 | |
Lorraine Labarre, L.c.s.w. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Bayonet St, Suite 202, New London, CT 06320 Phone: 860-443-4163 | |
Recover 12 Solutions, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Fuller St, New London, CT 06320 Phone: 860-389-4327 Fax: 860-574-9676 | |
Child And Family Agency Of Southeastern Connecticut, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 Vauxhall St, New London, CT 06320 Phone: 860-437-4550 | |
Spectrum Family Therapy Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 Granite St Ste 1b, New London, CT 06320 Phone: 860-857-4114 | |
Empowering Connections Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 164 Hempstead St, New London, CT 06320 Phone: 860-910-4881 |