| Connecticut Behavioral Health, Llc | |
|
673 S Main St Cheshire CT 06410-3149 | |
| (203) 271-1430 | |
| (203) 271-1800 |
| Full Name | Connecticut Behavioral Health, Llc |
|---|---|
| Speciality | Counselor |
| Location | 673 S Main St, Cheshire, Connecticut |
| Authorized Official Name and Position | Jonathan J Pedro (OWNER) |
| Authorized Official Contact | 2032711430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Connecticut Behavioral Health, Llc 673 S Main St Cheshire CT 06410-3149 Ph: (203) 271-1430 | Connecticut Behavioral Health, Llc 673 S Main St Cheshire CT 06410-3149 Ph: (203) 271-1430 |
| NPI Number | 1235171828 |
|---|---|
| Provider Enumeration Date | 06/11/2006 |
| Last Update Date | 10/29/2015 |
| Medicare PECOS PAC ID | 0143260117 |
|---|---|
| Medicare Enrollment ID | O20050510000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235171828 | NPI | - | NPPES |
| Provider Name | Jonathan J Pedro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841320876 PECOS PAC ID: 0042250011 Enrollment ID: I20050510000112 |
| Provider Name | Ryan M Loss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538298682 PECOS PAC ID: 3072555424 Enrollment ID: I20050525000732 |
| Provider Name | Shelly Mcnulty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306167697 PECOS PAC ID: 1557749843 Enrollment ID: I20220526002776 |
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