| Sound Community Services, Inc. | |
|
21 Montauk Avenue New London CT 06320-4906 | |
| (860) 271-4783 | |
| (860) 390-1463 |
| Full Name | Sound Community Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 21 Montauk Avenue, New London, Connecticut |
| Authorized Official Name and Position | Gino Demaio (CEO) |
| Authorized Official Contact | 8604396400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sound Community Services, Inc. Po Box 390 New London CT 06320-0390 Ph: (860) 271-4783 | Sound Community Services, Inc. 21 Montauk Avenue New London CT 06320-4906 Ph: (860) 271-4783 |
| NPI Number | 1396700886 |
|---|---|
| Provider Enumeration Date | 04/19/2006 |
| Last Update Date | 10/05/2022 |
| Certification Date | 10/05/2022 |
| Medicare PECOS PAC ID | 7517981517 |
|---|---|
| Medicare Enrollment ID | O20060117001127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396700886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Luis R Gonzalez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801863220 PECOS PAC ID: 2567350408 Enrollment ID: I20040310000888 |
| Provider Name | Lisa J Moon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427112390 PECOS PAC ID: 4587741012 Enrollment ID: I20140826000249 |
| Provider Name | Nichole Fenton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003230624 PECOS PAC ID: 1355655952 Enrollment ID: I20150727001174 |
| Provider Name | Amy Roe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275934226 PECOS PAC ID: 1850654286 Enrollment ID: I20180417000593 |
| Provider Name | Cassandra M Rice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982189056 PECOS PAC ID: 2668725581 Enrollment ID: I20181023002073 |
| Provider Name | Judy Bolanos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629425384 PECOS PAC ID: 5991042665 Enrollment ID: I20190204001839 |
| Provider Name | Elizabeth R Czikowsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457940041 PECOS PAC ID: 5395150239 Enrollment ID: I20210226000894 |
| Provider Name | Sharma Piersall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912531138 PECOS PAC ID: 3274936091 Enrollment ID: I20210730000527 |
| Provider Name | Jodi Cascella |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013477058 PECOS PAC ID: 9931504362 Enrollment ID: I20210824001981 |
| Provider Name | Chrystal Aline Sparks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063995124 PECOS PAC ID: 7214308378 Enrollment ID: I20230127001417 |
| Provider Name | Kathleen Grega |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053726620 PECOS PAC ID: 4587035597 Enrollment ID: I20230130000279 |
| Provider Name | William L. Kornegay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366160277 PECOS PAC ID: 1557733847 Enrollment ID: I20230215000484 |
| Provider Name | Alison George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851092266 PECOS PAC ID: 6204378466 Enrollment ID: I20240604001752 |
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Child And Family Agency Of Southeastern Connecticut, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7 Vauxhall St, New London, CT 06320 Phone: 860-437-4550 | |
Spectrum Family Therapy Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 Granite St Ste 1b, New London, CT 06320 Phone: 860-857-4114 | |
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