| Key Therapy Llc | |
|
731 Main St Ste 122 Monroe CT 06468-2872 | |
| (203) 261-7090 | |
| (888) 856-3413 |
| Full Name | Key Therapy Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 731 Main St Ste 122, Monroe, Connecticut |
| Authorized Official Name and Position | Samantha Lee Birtwell (LMFT) |
| Authorized Official Contact | 2033006414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Key Therapy Llc 13 Roosevelt Dr Newtown CT 06470-2035 Ph: (203) 300-6414 | Key Therapy Llc 731 Main St Ste 122 Monroe CT 06468-2872 Ph: (203) 261-7090 |
| NPI Number | 1114393493 |
|---|---|
| Provider Enumeration Date | 08/20/2015 |
| Last Update Date | 07/24/2020 |
| Certification Date | 07/24/2020 |
| Medicare PECOS PAC ID | 6204185010 |
|---|---|
| Medicare Enrollment ID | O20180827003149 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114393493 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 001736 (Connecticut) | Primary |
| Provider Name | Nanci E Kaczegowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487657276 PECOS PAC ID: 0749273985 Enrollment ID: I20040405001253 |
| Provider Name | Holly Marini |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1073531927 PECOS PAC ID: 4981674926 Enrollment ID: I20040728000560 |
| Provider Name | Jose Olmo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346338779 PECOS PAC ID: 6901817824 Enrollment ID: I20060508000130 |
| Provider Name | Maureen D Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083755300 PECOS PAC ID: 6305918590 Enrollment ID: I20080703000192 |
| Provider Name | Kathleen Lcsw Treacy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851588669 PECOS PAC ID: 5294989778 Enrollment ID: I20130209000017 |
| Provider Name | Charmaine T Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083845846 PECOS PAC ID: 2365668019 Enrollment ID: I20140801000770 |
| Provider Name | Marissa Garfunkel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710384748 PECOS PAC ID: 2466778774 Enrollment ID: I20150304001431 |
| Provider Name | Jessica Lima |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275911695 PECOS PAC ID: 5395047963 Enrollment ID: I20160113002799 |
| Provider Name | Julia Teitelbaum |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346599750 PECOS PAC ID: 8224386255 Enrollment ID: I20180807002179 |
| Provider Name | Leina G Fruhbauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326569237 PECOS PAC ID: 2668721267 Enrollment ID: I20180815000878 |
| Provider Name | Briana Marino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700240181 PECOS PAC ID: 5193078608 Enrollment ID: I20181031001323 |
| Provider Name | Christopher J Gergovich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235394594 PECOS PAC ID: 1355631789 Enrollment ID: I20181108002235 |
| Provider Name | Joshua Valinsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437643608 PECOS PAC ID: 8426302357 Enrollment ID: I20181113001861 |
| Provider Name | Melissa Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588139497 PECOS PAC ID: 2062757594 Enrollment ID: I20190102002068 |
| Provider Name | Kimberly Fahey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992014096 PECOS PAC ID: 0840531968 Enrollment ID: I20190417002389 |
| Provider Name | Nathalia L Dorival |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336578681 PECOS PAC ID: 8820327992 Enrollment ID: I20190916001182 |
| Provider Name | Kelley Kendall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841646742 PECOS PAC ID: 0547694705 Enrollment ID: I20191220000893 |
| Provider Name | Dana Lyn Saad |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649811266 PECOS PAC ID: 2466887146 Enrollment ID: I20200128000576 |
| Provider Name | Mary Alice Poupon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073949509 PECOS PAC ID: 4587946975 Enrollment ID: I20200811000676 |
| Provider Name | Linda Valera |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104450519 PECOS PAC ID: 4385095942 Enrollment ID: I20240108004596 |
| Provider Name | Meghan Emanuelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861170318 PECOS PAC ID: 8527419134 Enrollment ID: I20240109000127 |
| Provider Name | Richard Michael Gorman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851863294 PECOS PAC ID: 4880045368 Enrollment ID: I20240109002862 |
| Provider Name | Emi Fukuda |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851855910 PECOS PAC ID: 3476904830 Enrollment ID: I20240110001216 |
| Provider Name | Lisa C Hughes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619497328 PECOS PAC ID: 8820441611 Enrollment ID: I20240129001142 |
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