PSYCHIATRIC MEDICINE CENTER PC (NPI# 1477602217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477602217 |
| Entity Type | Organization |
| Organization Name | PSYCHIATRIC MEDICINE CENTER PC |
| Practice Address |
501 Ocean Ave Psychiatric Medicine Center PC New London CT 06320 |
| Practice Telephone | 8604426364 |
| Practice Fax Number | 8604479977 |
| Mailing Telephone | 8604426364 |
| Mailing Fax Number | 8604479977 |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. PAMELA GRAVES (CREDENTIALING) |
| Authorized Official Telephone | 8604426364 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Street Address |
501 OCEAN AVE PSYCHIATRIC MEDICINE CENTER PC |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508814765 | Gary John Fox | Social Worker | 501 Ocean Ave, New London, CT 06320 | 2006-05-04 |
| 1376692111 | Psychiatric Medicine Center, PC | Nurse Practitioner | 501 Ocean Ave, New London, CT 06320-4521 | 2007-01-10 |
| 1649329483 | Psychiatric Medicine Center, PC | Social Worker | 501 Ocean Ave, New London, CT 06320-4521 | 2007-01-10 |
| 1740339589 | Psychiatric Medicine Center, PC | Counselor | 501 Ocean Ave, New London, CT 06320-4521 | 2007-01-10 |
| 1528116118 | Psychiatric Medicine Center, PC | Psychiatry & Neurology | 501 Ocean Ave, New London, CT 06320-4521 | 2007-01-08 |
| 1912084112 | Jill C Sandora | Social Worker | 501 Ocean Ave, Psychiatric Medicine Center PC, New London, CT 06320 | 2006-11-01 |
| 1326064338 | Lynn A Mccaffrey | Social Worker | 501 Ocean Ave, Psychiatric Medicine Center, New London, CT 06320 | 2006-07-14 |
| 1609826106 | Iris June Bernau | Social Worker | 501 Ocean Ave, New London, CT 06320 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824891 | Shilpi Jain | Physical Therapist | 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 | 2020-06-05 |
| 1174009641 | Catherine Hinojosa | Nurse Practitioner | 1 Shaws Cove, New London, CT 06320 | 2018-07-17 |
| 1043668320 | Cultivate & Grow Inc. | Counselor | 302 State St Suite 307, New London, CT 06320 | 2016-05-27 |
| 1295137263 | Jacqueline Durnell | Registered Nurse | 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 | 2014-09-22 |
| 1922427541 | Corina Vendetto | Registered Nurse | 245 Shaw St., New London, CT 06320 | 2014-04-10 |
| 1912329962 | Janelle Posey-green | Social Worker | 302 State St., Suite 201, New London, CT 06320 | 2014-01-10 |
| 1750622692 | Cynthia Mitchell | Social Worker | 65b Michael Rd, New London, CT 06320 | 2013-03-01 |
| 1518254507 | Simon J Shapiro | Physical Medicine & Rehabilitation | 190 Howard Avenue, New London, CT 06320 | 2011-06-29 |
| 1184876708 | Jane P Genido-trujillo | Nurse Practitioner | 270 Mohegan Ave., Student Health Services, New London, CT 06320 | 2008-10-14 |
| 1932356284 | Gerard Joseph Ventura | Dentist | 21 Montauk Ave., Suite 102, New London, CT 06320 | 2008-08-19 |
| Find all providers in zip 06320 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164527404 | Louis Henry Reich | Psychiatry & Neurology | 292 Montauk Avenue, New London, CT 06320 | 2006-09-13 |
| 1144282898 | Henry F Crabbe | Psychiatry & Neurology | 5 Shaws Cv Ste 207, New London, CT 06320-4974 | 2006-04-06 |
| 1215909379 | Stephen Glenn Vance | Psychiatry & Neurology | 21 Montauk Ave, New London, CT 06320-4906 | 2006-02-03 |
| 1376843011 | Amanda W Speicher | Psychiatry & Neurology | 165 State St, Suite 200, New London, CT 06320-6397 | 2010-10-28 |
| 1982899803 | Julia Chase Brand | Psychiatry & Neurology | 41 Fair Harbour Pl, New London, CT 06320-4710 | 2007-09-13 |
| 1669683207 | Connecticut Behavioral Health Assoc. P.c | Psychiatry & Neurology | 41 Fair Harbour Pl, New London, CT 06320-4710 | 2007-05-25 |
| 1538282710 | Charles Andrew Batt | Psychiatry & Neurology | 14 Blueberry Lane, New London, NH 03257 | 2007-04-10 |
| 1528116118 | Psychiatric Medicine Center, PC | Psychiatry & Neurology | 501 Ocean Ave, New London, CT 06320-4521 | 2007-01-08 |
| 1881774354 | Bassam Awwa | Psychiatry & Neurology | 41 Fair Harbour Pl, New London, CT 06320-4710 | 2006-10-17 |
| 1629158126 | Connecticut Behavioral Health Assoc, P.C. | Psychiatry & Neurology | 41 Fair Harbour Pl, New London, CT 06320-4710 | 2006-10-17 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 06320 |
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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.