Empowering Connections Llc | |
164 Hempstead St New London CT 06320-5638 | |
(860) 910-4881 | |
Not Available |
Full Name | Empowering Connections Llc |
---|---|
Speciality | Community/Behavioral Health |
Location | 164 Hempstead St, New London, Connecticut |
Authorized Official Name and Position | Katelyn Baez (CLINICIAN) |
Authorized Official Contact | 8609104881 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Empowering Connections Llc 31 Saint Joseph Ct Groton CT 06340-4815 Ph: (860) 910-4881 | Empowering Connections Llc 164 Hempstead St New London CT 06320-5638 Ph: (860) 910-4881 |
NPI Number | 1174109136 |
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Provider Enumeration Date | 03/21/2021 |
Last Update Date | 06/14/2023 |
Certification Date | 06/14/2023 |
Medicare PECOS PAC ID | 8325437825 |
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Medicare Enrollment ID | O20211122001108 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174109136 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Katelyn Baez |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1003324195 PECOS PAC ID: 8426467697 Enrollment ID: I20210429002510 |
Provider Name | Shayna Elyse Provencher |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1801593199 PECOS PAC ID: 8729438163 Enrollment ID: I20231227000948 |
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