| Mindful Mental Health Ct South Llc | |
|
31 Kachele St Easton CT 06612-2063 | |
| (203) 551-7301 | |
| Not Available |
| Full Name | Mindful Mental Health Ct South Llc |
|---|---|
| Speciality | Psychologist |
| Location | 31 Kachele St, Easton, Connecticut |
| Authorized Official Name and Position | Ronald Broden (CEO) |
| Authorized Official Contact | 9147208509 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Mental Health Ct South Llc 31 Kachele St Easton CT 06612-2063 Ph: (203) 551-7301 | Mindful Mental Health Ct South Llc 31 Kachele St Easton CT 06612-2063 Ph: (203) 551-7301 |
| NPI Number | 1497338396 |
|---|---|
| Provider Enumeration Date | 04/29/2021 |
| Last Update Date | 06/14/2021 |
| Certification Date | 06/14/2021 |
| Medicare PECOS PAC ID | 5395145932 |
|---|---|
| Medicare Enrollment ID | O20210618000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497338396 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Mary Robbins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063657013 PECOS PAC ID: 9931097763 Enrollment ID: I20040304000963 |
| Provider Name | Eric Brysgel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912950213 PECOS PAC ID: 6709817943 Enrollment ID: I20050826000509 |
| Provider Name | Beth L Zukowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598716128 PECOS PAC ID: 7012935927 Enrollment ID: I20051109000796 |
| Provider Name | Rebecca Krusinski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871791384 PECOS PAC ID: 7113017781 Enrollment ID: I20071219000579 |
| Provider Name | Irma I Santiago-moin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699910844 PECOS PAC ID: 9537209796 Enrollment ID: I20091218000229 |
| Provider Name | Kathleen R Schober |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316297419 PECOS PAC ID: 7214174531 Enrollment ID: I20130506000132 |
| Provider Name | Jacqueline Ofria |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962952622 PECOS PAC ID: 7618379827 Enrollment ID: I20210712000438 |
| Provider Name | Cassandra Lynn Manger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639786072 PECOS PAC ID: 2062816390 Enrollment ID: I20210810000300 |
| Provider Name | Veronica Ellison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295400257 PECOS PAC ID: 1153726856 Enrollment ID: I20210818002302 |
| Provider Name | Gayle Paquin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154999431 PECOS PAC ID: 8628466679 Enrollment ID: I20211026000141 |
| Provider Name | Kelly Meany |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497209167 PECOS PAC ID: 9537558770 Enrollment ID: I20211110000754 |
| Provider Name | Michele Jakab |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710644133 PECOS PAC ID: 0446640825 Enrollment ID: I20211126000037 |
| Provider Name | Kaitlin Magalnick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548918709 PECOS PAC ID: 1153717830 Enrollment ID: I20220405002753 |
| Provider Name | Caroline Contreras |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548998412 PECOS PAC ID: 7810370897 Enrollment ID: I20220824002171 |
| Provider Name | Jennifer Reid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568094894 PECOS PAC ID: 8325422488 Enrollment ID: I20220908003068 |
| Provider Name | Aneta Szczypiorski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760102180 PECOS PAC ID: 3274918941 Enrollment ID: I20220915002700 |
| Provider Name | Sarah Mary Zammiello |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811606437 PECOS PAC ID: 9133599053 Enrollment ID: I20230110000933 |
| Provider Name | Mary Cassandra Foster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770835746 PECOS PAC ID: 2466853346 Enrollment ID: I20230919000448 |
| Provider Name | Edith Elin Snyderman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437850229 PECOS PAC ID: 4587011366 Enrollment ID: I20231116000436 |
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