ALICIA BRENGMAN (NPI# 1306310255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306310255 |
| Entity Type | Individual |
| Full Name | ALICIA BRENGMAN |
| Credential | MS |
| Practice Address |
500 Poquonnock Rd Groton CT 06340-4568 |
| Mailing Address |
255 Hempstead St New London CT 06320-6204 |
| Practice Telephone | 8604452191 |
| Practice Fax Number | 8604491869 |
| Mailing Telephone | 8604432896 |
| Mailing Fax Number | 8604425909 |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-01-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
500 POQUONNOCK RD |
| City | GROTON |
| State | CT |
| Zip Code | 06340-4568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881871168 | Child and Family Agency of Southeastern Connecticut, Inc. | Clinic/Center | 500 Poquonnock Rd, Groton, CT 06340-4568 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871041061 | Mary Parker | Counselor | 495 Gold Star Hwy Ste 324, Groton, CT 06340-6230 | 2016-09-15 |
| 1770990525 | Erika Bell | Counselor | 1 Stonecleave Ln, Groton, MA 01450-1550 | 2014-07-14 |
| 1407981525 | John Thomas Walsh | Counselor | 68 Hollis St., Groton, MA 01450-0073 | 2007-02-22 |
| 1457498164 | Scott T. Serviss | Counselor | 21 Chicago Ave, Groton, CT 06340-4907 | 2007-01-31 |
| 1841355948 | Jocelyn Lopatin | Counselor | 149 Raddin Rd, Groton, MA 01450-1413 | 2006-12-27 |
| 1609498526 | Rachel Skelton | Counselor | 1353 Gold Star Hwy, Groton, CT 06340-2739 | 2020-05-13 |
| 1124368261 | Linda Hammill | Counselor | 274 Main St, Groton, MA 01450-1236 | 2013-02-27 |
| 1174889109 | Susannah Jane Forte Stahr | Counselor | 591 Poquonnock Rd, Groton, CT 06340-4571 | 2012-04-04 |
| 1366725426 | Cynthia A Petelle | Counselor | 274 Main St, Groton, MA 01450-1236 | 2011-09-26 |
| 1285811265 | Sara Ann M. Jakub | Counselor | 591 Poquonnock Rd, Groton, CT 06340-4571 | 2008-01-22 |
| Find all providers in GROTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.