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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 251S00000X | Community/Behavioral Health | Agencies |
Street Address |
85B WALL ST |
City | MADISON |
State | CT |
Zip Code | 06443-3121 |
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 Code | 251S00000X |
Grouping | Agencies |
Classification | Community/Behavioral Health |
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] |
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 |
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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.