SHORE WELLNESS CT


Address: 85b Wall St, Madison, CT 06443-3121
Phone: 2038960101

SHORE WELLNESS CT (NPI# 1316464191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316464191
Entity Type Organization
Organization Name SHORE WELLNESS CT
Practice Address 85b Wall St
Madison
CT 06443-3121
Mailing Address 210 Pine St Apt 315
Manchester
CT 06040-8418
Practice Telephone 2038960101
Mailing Telephone 8607598346
Enumeration Date 2017-08-23
Last Update Date 2017-08-23
Authorized Official Name ERICA BALOGA (CLINICIAN)
Authorized Official Telephone 2038960101
Authorized Official Credential LMFT
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 251S00000X Community/Behavioral Health Agencies

Office Location

Street Address 85B WALL ST
City MADISON
State CT
Zip Code 06443-3121

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1194127506 Heather R. Clinton Social Worker 847 West Main Street, Suite 3, Branford, CT 06443 2014-09-17
1477973378 Katrina Louise Furey Psychiatry & Neurology 147 Durham Rd Ste 12a-ne, Madison, CT 06443 2014-04-18
1972920114 Elizabeth Laberee Internal Medicine 80 Devonshire Lane, Madison, CT 06443 2014-03-26
1588007314 Avery Grauer Psychiatry & Neurology 175 Copse Road, Madison, CT 06443 2013-04-11
1295077790 Gordon Seth Cohen Pathology 3 Silo Hill Road, Madison, CT 06443 2013-03-22
1073750493 Darlene F. Talavera Occupational Therapist 22 Overshore Drive, Madison, CT 06443 2009-01-08
1013182518 Susan Jean Isaac Social Worker 105 Winding Road, Unit 2, Madison, CT 06443 2008-04-25
1083893606 Kornelia Keszler, Md, PC Internal Medicine 1-b Meigswood Ave, Madison, CT 06443 2007-10-31
1811181126 Traci Marando Nurse Practitioner 20 Madrina Lane, Madison, CT 06443 2007-08-29
1790803419 Linda L. Young Social Worker 2 Samson Rock Drive, Unit 2g, Madison, CT 06443 2007-03-27
Find all providers in zip 06443

Taxonomy Information

Taxonomy Code 251S00000X
Grouping Agencies
Classification Community/Behavioral Health

Taxonomy Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1871141366 Boone Memorial Hospital, Inc. Community/Behavioral Health 467 Main St Ste 4, Madison, WV 25130-2200 2019-08-28
1154838399 Leslie Smith Lpc LLC Community/Behavioral Health 650 Sun Temple Dr, Madison, AL 35758-8621 2018-01-09
1497268817 Imagine A Childs Capacity LLC Community/Behavioral Health 128 E Olin Ave Ste 201, Madison, WI 53713-1467 2017-11-07
1407302532 Aba Steps LLC Community/Behavioral Health 3 Niles Ave, Madison, NJ 07940-2310 2016-08-29
1245786680 Michelle Ayres, Ms, Lmft Community/Behavioral Health 111 S 1st St # 103, Madison, WI 53704-5244 2016-08-26
1124471412 Lifeworks Counseling Community/Behavioral Health 940 Ebenezer Blvd., Madison, MS 39110 2016-07-21
1184078628 Bridgeway Counseling Community/Behavioral Health 540 Hughes Rd Ste 3, Madison, AL 35758-8959 2016-04-21
1588022206 Moore Counseling Services Community/Behavioral Health 808 Nw 3rd St, Madison, SD 57042-2518 2016-02-09
1073988051 Killebrew Psychological Services, LLC Community/Behavioral Health 133 Berry Ln, Madison, MS 39110-8616 2015-12-02
1952790107 Dr. Kirmani-moe, LLC Community/Behavioral Health 7818 Big Sky Dr Ste 103, Madison, WI 53719-2840 2015-01-12
Find all providers in MADISON

Competitor

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City MADISON
Zip Code 06443

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Dataset Information

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.

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