| Optum Behavioral Care Of Connecticut, P.c. | |
|
200 W Town St Norwich CT 06360-2112 | |
| (203) 819-0789 | |
| Not Available |
| Full Name | Optum Behavioral Care Of Connecticut, P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 200 W Town St, Norwich, Connecticut |
| Authorized Official Name and Position | Amanda Bronson (CEO) |
| Authorized Official Contact | 7045066267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optum Behavioral Care Of Connecticut, P.c. 67 Burnside Ave East Hartford CT 06108-3408 Ph: (952) 246-4564 | Optum Behavioral Care Of Connecticut, P.c. 200 W Town St Norwich CT 06360-2112 Ph: (203) 819-0789 |
| NPI Number | 1922870955 |
|---|---|
| Provider Enumeration Date | 10/24/2023 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Medicare PECOS PAC ID | 9436502879 |
|---|---|
| Medicare Enrollment ID | O20240321001614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922870955 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Ryan Marc Lieberman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548483654 PECOS PAC ID: 9830107762 Enrollment ID: I20060404000080 |
| Provider Name | Lynn Mccaffrey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326064338 PECOS PAC ID: 4385720408 Enrollment ID: I20080328000480 |
| Provider Name | Megan Klein |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1437232766 PECOS PAC ID: 5698963171 Enrollment ID: I20101228000527 |
| Provider Name | Laura Palmese |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184906448 PECOS PAC ID: 9335392950 Enrollment ID: I20130110000366 |
| Provider Name | Sharif J Okasha |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518027325 PECOS PAC ID: 1254477342 Enrollment ID: I20150130000405 |
| Provider Name | Renee L Lacadie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265818355 PECOS PAC ID: 7618285008 Enrollment ID: I20151005002316 |
| Provider Name | Shelly Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518418300 PECOS PAC ID: 3072927979 Enrollment ID: I20210204002759 |
| Provider Name | Madison Mcnally Dahm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700407905 PECOS PAC ID: 3779991245 Enrollment ID: I20210421002951 |
| Provider Name | Kyle John Sunderland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144779968 PECOS PAC ID: 1456790898 Enrollment ID: I20240417003018 |
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