STONINGTON BEHAVIORAL HEALTH INC (NPI# 1306361662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306361662 |
| Entity Type | Organization |
| Organization Name | STONINGTON BEHAVIORAL HEALTH INC |
| Other Organization Name | STONINGTON INSTITUTE |
| Practice Address |
618 Poquonnock Rd Groton CT 06340 |
| Practice Telephone | 8604453021 |
| Mailing Telephone | 8604453021 |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2017-08-08 |
| Authorized Official Name | STEVE FILTON (VICE PRESIDENT) |
| Authorized Official Telephone | 6107683300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| N | 103TP2701X |
Psychologist Specialization: Group Psychotherapy |
Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 0060 | 05 | |
| CT | STATE | 0482 | 01 |
| Other Name | Type Code |
|---|---|
| Stonington Institute | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225097231 | Stonington Behavioral Health Inc | Substance Abuse Rehabilitation Facility | 75 Swantown Hill Rd, North Stonington, CT 06359-1022 | 2006-03-20 |
| Street Address |
618 POQUONNOCK RD |
| City | GROTON |
| State | CT |
| Zip Code | 06340 |
| 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 |
| 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 |
| 1770932220 | Matthew Kermit Lee | Military Health Care Provider | 465 Trout Ave, Numi, Groton, CT 06340 | 2016-06-06 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326182726 | Gerald L Borofsky | Psychologist | 641 Chicopee Row, Groton, MA 01450-1457 | 2007-02-18 |
| 1821198508 | Thomas Joseph Maciolek | Psychologist | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2006-09-23 |
| 1992733901 | Robert Michael Bahm | Psychologist | 27 Carmichael Way, Groton, MA 01450-2081 | 2006-06-29 |
| 1801868732 | Christine Elizabeth Musello | Psychologist | 142 Main St, Groton, MA 01450-1271 | 2006-02-04 |
| 1568996528 | Jbw Psychological Services LLC | Psychologist | 8 W Main St, Groton, MA 01450-1631 | 2017-04-17 |
| 1437607538 | Growing Potential, LLC | Psychologist | 495 Gold Star Hwy Ste 324, Groton, CT 06340-6230 | 2016-09-17 |
| 1467726737 | Maxine L Varanko | Psychologist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2012-03-02 |
| 1952620015 | Jennifer Beth Warkentin | Psychologist | 8 W Main St, Groton, MA 01450-1631 | 2010-05-27 |
| 1649596214 | Jennifer Selden, Ph.d., LLC | Psychologist | 495 Gold Star Hwy, Suite 200, Groton, CT 06340-6228 | 2010-04-08 |
| 1740436344 | Fort Hill Counselors LLC | Psychologist | 1 Fort Hill Rd, Groton, CT 06340-4799 | 2008-08-14 |
| 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.