Reset & Restart Mental Health & Wellness Services | |
701 Cottage Grove Rd Ste A230 Bloomfield CT 06002-3084 | |
(860) 706-7592 | |
Not Available |
Full Name | Reset & Restart Mental Health & Wellness Services |
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Speciality | Counselor |
Location | 701 Cottage Grove Rd Ste A230, Bloomfield, Connecticut |
Authorized Official Name and Position | Renesha Nichols (OWNER) |
Authorized Official Contact | 8607067592 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Reset & Restart Mental Health & Wellness Services 701 Cottage Grove Rd Ste A230 Bloomfield CT 06002-3084 Ph: (860) 706-7592 | Reset & Restart Mental Health & Wellness Services 701 Cottage Grove Rd Ste A230 Bloomfield CT 06002-3084 Ph: (860) 706-7592 |
NPI Number | 1811389794 |
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Provider Enumeration Date | 03/02/2015 |
Last Update Date | 06/01/2023 |
Certification Date | 06/01/2023 |
Medicare PECOS PAC ID | 3476990409 |
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Medicare Enrollment ID | O20240326001448 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811389794 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | 187695384 (Connecticut) | Primary |
Provider Name | Renesha L Nichols |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1750549853 PECOS PAC ID: 9638408289 Enrollment ID: I20190909000732 |
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