| Psy-visions Of Connecticut, Llc | |
|
88 Main St S Ste B201 Southbury CT 06488-2276 | |
| (203) 405-1745 | |
| (203) 405-1745 |
| Full Name | Psy-visions Of Connecticut, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 88 Main St S Ste B201, Southbury, Connecticut |
| Authorized Official Name and Position | Mark D. Stracks (PRESIDENT) |
| Authorized Official Contact | 7067188056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psy-visions Of Connecticut, Llc 370 Weekeepeemee Rd Woodbury CT 06798-1621 Ph: (706) 718-8056 | Psy-visions Of Connecticut, Llc 88 Main St S Ste B201 Southbury CT 06488-2276 Ph: (203) 405-1745 |
| NPI Number | 1659808699 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 05/22/2017 |
| Medicare PECOS PAC ID | 2668744202 |
|---|---|
| Medicare Enrollment ID | O20170817000455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659808699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 54602 (Connecticut) | Primary |
| Provider Name | Mark D. Stracks |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437215456 PECOS PAC ID: 6002821642 Enrollment ID: I20151218001211 |
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