| Livewell Alliance, Inc. | |
|
1261 S Main St Plantsville CT 06479-1750 | |
| (860) 628-9000 | |
| Not Available |
| Full Name | Livewell Alliance, Inc. |
|---|---|
| Speciality | Occupational Therapist |
| Location | 1261 S Main St, Plantsville, Connecticut |
| Authorized Official Name and Position | Anya Marisse Bounds (DIR OF REV & REIMBURSEMENT) |
| Authorized Official Contact | 8606283059 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Livewell Alliance, Inc. 1261 S Main St Plantsville CT 06479-1750 Ph: (860) 628-9000 | Livewell Alliance, Inc. 1261 S Main St Plantsville CT 06479-1750 Ph: (860) 628-9000 |
| NPI Number | 1396271532 |
|---|---|
| Provider Enumeration Date | 05/09/2017 |
| Last Update Date | 03/31/2022 |
| Certification Date | 03/31/2022 |
| Medicare PECOS PAC ID | 1052449162 |
|---|---|
| Medicare Enrollment ID | O20170911000483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396271532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 009647 (Connecticut) | Secondary |
| 225X00000X | Occupational Therapist | 003405 (Connecticut) | Primary |
| Provider Name | Linda L Denton |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215217757 PECOS PAC ID: 5294984902 Enrollment ID: I20121012000139 |
| Provider Name | Daniel Belonick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225571763 PECOS PAC ID: 3274809140 Enrollment ID: I20171019002593 |
| Provider Name | Caroline Kate Keefe |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295931178 PECOS PAC ID: 3870854466 Enrollment ID: I20180222000482 |
| Provider Name | Teresa J Lohr |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306308952 PECOS PAC ID: 1850632001 Enrollment ID: I20190416002337 |
| Provider Name | Anne M Graikoski |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376024059 PECOS PAC ID: 1557750015 Enrollment ID: I20211123000543 |
| Provider Name | Evelyn Katherine Puzio |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699464305 PECOS PAC ID: 5294192340 Enrollment ID: I20230605001457 |
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