| Bedrock Wellness | |
|
416 Highland Ave Ste B Cheshire CT 06410-2531 | |
| (203) 599-1492 | |
| Not Available |
| Full Name | Bedrock Wellness |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 416 Highland Ave Ste B, Cheshire, Connecticut |
| Authorized Official Name and Position | Heather R Laselle (EXECUTIVE CLINICAL DIRECTOR) |
| Authorized Official Contact | 2035991492 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bedrock Wellness 416 Highland Ave Ste B Cheshire CT 06410-2531 Ph: (203) 599-1492 | Bedrock Wellness 416 Highland Ave Ste B Cheshire CT 06410-2531 Ph: (203) 599-1492 |
| NPI Number | 1710452255 |
|---|---|
| Provider Enumeration Date | 10/11/2018 |
| Last Update Date | 08/25/2022 |
| Certification Date | 08/25/2022 |
| Medicare PECOS PAC ID | 5698143923 |
|---|---|
| Medicare Enrollment ID | O20240222002712 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710452255 | NPI | - | NPPES |
| 008083434 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Abigail Brewerton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396377560 PECOS PAC ID: 1254728363 Enrollment ID: I20240222002981 |
| Provider Name | Dana Michelle Barker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386278075 PECOS PAC ID: 6800232547 Enrollment ID: I20240315002372 |
| Provider Name | Kathleen Denise Bartkus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629335666 PECOS PAC ID: 5496192874 Enrollment ID: I20240320003883 |
| Provider Name | Rebecca L Russo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831455146 PECOS PAC ID: 9234577164 Enrollment ID: I20240410003139 |
| Provider Name | Heather R Laselle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649511437 PECOS PAC ID: 9234507575 Enrollment ID: I20240422000774 |
| Provider Name | Erin Byrne |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497181929 PECOS PAC ID: 9739529355 Enrollment ID: I20240430002869 |
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