| Professional Resource Group Pc | |
|
207 Storrs Rd # 174 Mansfield Center CT 06250-1638 | |
| (860) 456-4604 | |
| (860) 456-1738 |
| Full Name | Professional Resource Group Pc |
|---|---|
| Speciality | Psychologist |
| Location | 207 Storrs Rd # 174, Mansfield Center, Connecticut |
| Authorized Official Name and Position | Gary P Kanabay (DIRECTOR PRESIDENT) |
| Authorized Official Contact | 8604564604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Professional Resource Group Pc 207 Storrs Rd # 174 Mansfield Center CT 06250-1638 Ph: (860) 456-4604 | Professional Resource Group Pc 207 Storrs Rd # 174 Mansfield Center CT 06250-1638 Ph: (860) 456-4604 |
| NPI Number | 1710019963 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 05/01/2014 |
| Medicare PECOS PAC ID | 5890703722 |
|---|---|
| Medicare Enrollment ID | O20060404000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710019963 | NPI | - | NPPES |
| 004398047 | Medicaid | CT | |
| 008002985 | Medicaid | CT | |
| 004255057 | Medicaid | CT | |
| 620000199 | Other | CT | MEDICARE |
| 008033020 | Medicaid | CT | |
| 297211 | Other | MHN | |
| C007612 | Other | TRICARE | |
| 004255007 | Medicaid | CT |
| Provider Name | Gary P Kanabay |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164521753 PECOS PAC ID: 7618985540 Enrollment ID: I20120112000321 |
Mary Kinsella-shaw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 31 Warrenville Rd, Mansfield Center, CT 06250 Phone: 860-450-1173 | |
Ann M. Pacheco Lmft, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2 Mansfield Hollow Rd, Mansfield Center, CT 06250 Phone: 860-423-0877 | |
Tamara Vertefeuille, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 Storrs Rd, Mansfield Center, CT 06250 Phone: 860-456-4604 Fax: 860-450-1310 | |
Mount Hope Wellness Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Warrenville Rd, Mansfield Center, CT 06250 Phone: 860-429-2463 | |
Danielle N. Christian, Lcsw, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18 Ledgebrook Dr, Suite E-3, Mansfield Center, CT 06250 Phone: 860-428-0403 | |
Mark Schroeder Md, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 354 Warrenville Rd, Mansfield Center, CT 06250 Phone: 860-455-9879 | |
Natchaug Hospital, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 189 Storrs Road, Mansfield Center, CT 06250 Phone: 860-456-1311 Fax: 860-450-0165 |