| Connecticut Institute Of Behavioral Health Inc. | |
|
495 Gold Star Hwy Ste 224 Groton CT 06340-6230 | |
| (860) 326-5405 | |
| (860) 326-5571 |
| Full Name | Connecticut Institute Of Behavioral Health Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 495 Gold Star Hwy Ste 224, Groton, Connecticut |
| Authorized Official Name and Position | Maria Higgins (OFFICE MANAGER) |
| Authorized Official Contact | 8603265405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Connecticut Institute Of Behavioral Health Inc. 495 Gold Star Hwy Ste 224 Groton CT 06340-6230 Ph: (860) 326-5405 | Connecticut Institute Of Behavioral Health Inc. 495 Gold Star Hwy Ste 224 Groton CT 06340-6230 Ph: (860) 326-5405 |
| NPI Number | 1861866139 |
|---|---|
| Provider Enumeration Date | 11/24/2015 |
| Last Update Date | 05/25/2022 |
| Certification Date | 05/25/2022 |
| Medicare PECOS PAC ID | 1951609262 |
|---|---|
| Medicare Enrollment ID | O20160419002022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861866139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 041692 (Connecticut) | Primary |
| Provider Name | Ammar Traboulsi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225125610 PECOS PAC ID: 1355308495 Enrollment ID: I20041210000241 |
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