| Hartford Behaviora Health | |
|
2550 Main St Hartford CT 06120-1936 | |
| (860) 727-8703 | |
| (860) 548-2045 |
| Full Name | Hartford Behaviora Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 2550 Main St, Hartford, Connecticut |
| Authorized Official Name and Position | Susan Niemitz (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8607278703 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hartford Behaviora Health 2550 Main St Hartford CT 06120-1936 Ph: (860) 727-8703 | Hartford Behaviora Health 2550 Main St Hartford CT 06120-1936 Ph: (860) 727-8703 |
| NPI Number | 1972592186 |
|---|---|
| Provider Enumeration Date | 10/19/2005 |
| Last Update Date | 09/20/2007 |
| Medicare PECOS PAC ID | 9830185552 |
|---|---|
| Medicare Enrollment ID | O20040420001466 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972592186 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 0302 (Connecticut) | Primary |
| Provider Name | Vania Modesto Lowe |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316006638 PECOS PAC ID: 1254315013 Enrollment ID: I20040617001020 |
| Provider Name | Carole L Montano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336208396 PECOS PAC ID: 2264463389 Enrollment ID: I20050829000057 |
| Provider Name | Yvonne E Acosta-martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700979440 PECOS PAC ID: 5193726859 Enrollment ID: I20070123000423 |
| Provider Name | Debra J Forrest |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508088451 PECOS PAC ID: 9638263759 Enrollment ID: I20070920000456 |
| Provider Name | Mary Ann Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578794053 PECOS PAC ID: 3476681461 Enrollment ID: I20100512000766 |
| Provider Name | Rebekah R Hafford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235207846 PECOS PAC ID: 8527200336 Enrollment ID: I20130807000536 |
| Provider Name | Eileen C Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538200688 PECOS PAC ID: 5597991463 Enrollment ID: I20131125000200 |
| Provider Name | Asima A Zehgeer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437430683 PECOS PAC ID: 9931332517 Enrollment ID: I20140506001243 |
| Provider Name | Wanda Serrano-miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184715922 PECOS PAC ID: 1850514613 Enrollment ID: I20140523000144 |
| Provider Name | Anabell Ramos-merced |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215134085 PECOS PAC ID: 8022336965 Enrollment ID: I20150406000975 |
| Provider Name | Bonafacia Lebron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912393323 PECOS PAC ID: 5799004032 Enrollment ID: I20150507001535 |
| Provider Name | Michael Gregorio Rayel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073571022 PECOS PAC ID: 1951660851 Enrollment ID: I20180123001523 |
| Provider Name | Belinda Lovell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326538018 PECOS PAC ID: 8123370012 Enrollment ID: I20181003002565 |
| Provider Name | Giang Vo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891067559 PECOS PAC ID: 9234479361 Enrollment ID: I20190327001119 |
| Provider Name | Dhurga Devi Krishnamoorthy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295149607 PECOS PAC ID: 1850625104 Enrollment ID: I20190620002134 |
| Provider Name | Chijioke Nnanna Egbujo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164601548 PECOS PAC ID: 9830484005 Enrollment ID: I20191003000663 |
| Provider Name | Sabine Cayo-saylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508498825 PECOS PAC ID: 2264847342 Enrollment ID: I20210223002394 |
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