MONIQUE DUTRAM (NPI# 1447680632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447680632 |
| Entity Type | Individual |
| Full Name | MONIQUE DUTRAM |
| Practice Address |
391 Pomfret St Putnam CT 06260-1852 |
| Practice Telephone | 8609634971 |
| Practice Fax Number | 8609634979 |
| Mailing Telephone | 8609634971 |
| Mailing Fax Number | 8609634979 |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2013-11-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
391 POMFRET ST |
| City | PUTNAM |
| State | CT |
| Zip Code | 06260-1852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902899859 | Ayaz T Madraswalla | Family Medicine | 391 Pomfret St, Putnam, CT 06260-1852 | 2005-08-25 |
| 1962017913 | Allyson A Vandi | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-09-15 |
| 1881207645 | Joseph Coulanges | Licensed Practical Nurse | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-08-31 |
| 1134737125 | George Mcdonald | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-07-16 |
| 1699396994 | Ashley Carpenter | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-04-28 |
| 1114566981 | Randy N Munasami | Licensed Practical Nurse | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-12-27 |
| 1023669637 | Jordan Jones | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-09-25 |
| 1801445291 | Chelsea Scanlon | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-09-09 |
| 1528615119 | Kerri A Mccaughey | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-08-20 |
| 1831744168 | Eddy Pimental | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-08-05 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043838139 | Shayna Marie Robinson | Behavior Technician | 62 Providence Pike Suite E, Putnam, CT 06260 | 2020-07-06 |
| 1649896390 | Bethany Barrette | Behavior Technician | 682 Providence Pike Suite E, Putnam, CT 06260 | 2020-06-18 |
| 1902450448 | Jillian Bellman | Registered Nurse | 391 Pomfret Street, Putnam, CT 06260 | 2019-08-01 |
| 1285297390 | Jourhana Colon | Behavior Technician | 62 Providence Pike Ste E, Putnam, CT 06260 | 2019-04-16 |
| 1457839417 | Amplisound, Inc. | Hearing Instrument Specialist | 19 Quinebaug Avenue, Putnam, CT 06260 | 2018-08-01 |
| 1184095960 | Lori Bergeron | Counselor | 391 Pomret Street, Putnam, CT 06260 | 2015-10-19 |
| 1558619957 | Merinessa Macayaon Quintilla | Physical Therapist | 10 Thurber Road, Genesis - Matulaitis Nursing Home, Putnam, CT 06260 | 2012-08-16 |
| 1235496936 | Mohsin Haseeb | Internal Medicine | Day Kimball Hospital, 320 Pomfret Street, Putnam, CT 06260 | 2012-04-18 |
| 1588932529 | Lifehouse Community Care, LLC | Home Health | 554 Liberty Highway Unit 2, Putnam, CT 06260 | 2011-12-05 |
| 1942433032 | Connecticut Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 57 Providence Pike, Putnam, CT 06260 | 2009-08-24 |
| Find all providers in zip 06260 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912115916 | Cam Morin Bounds | Counselor | 96 Front St, Putnam, CT 06260 | 2007-05-21 |
| 1952458374 | Mary J Okeefe | Counselor | 96 Front Street, Suite D, Putnam, CT 06260 | 2007-01-05 |
| 1225448574 | Meghan Youmell | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2014-05-07 |
| 1518215920 | Susan Solis-castaneda | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2012-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235737735 | Southbury Adolescent and Young Adult Counseling Center LLC | Counselor | 385 Main St S Ste 217, Southbury, CT 06488-4246 | 2020-10-15 |
| 1821696675 | Bunny Catherina Rodriguez | Counselor | 60 Lake Rd, North Branford, CT 06471-1252 | 2020-10-14 |
| 1780282681 | Marcie Rivera | Counselor | 47 Coit St, New London, CT 06320-5924 | 2020-10-13 |
| 1003428897 | Francesca Nicole Porter | Counselor | 39 Burnham St, Enfield, CT 06082-6144 | 2020-08-21 |
| 1952912271 | Patience Ashong | Counselor | 191 High Ridge Dr, Bridgeport, CT 06606-4965 | 2020-08-11 |
| 1366051468 | Evan Hunter Jr. | Counselor | 53 Hawthorne Ave, Waterbury, CT 06708-4614 | 2020-07-24 |
| 1710505284 | Alfred Levi Greenleaf Jr. | Counselor | 51 Maheu St, Bristol, CT 06010-3051 | 2020-07-10 |
| 1316560089 | Sean Thomas Marcil | Counselor | 1776 Meriden Rd Rear Unitb, Wolcott, CT 06716-3341 | 2020-05-28 |
| 1396365706 | Angela M Massiello | Counselor | 192 Maple Ave, Uncasville, CT 06382-2018 | 2020-04-26 |
| 1750901005 | A Better Day Counseling Center LLC | Counselor | 403 New Litchfield St, Torrington, CT 06790-6640 | 2020-04-16 |
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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.