PORTERS HOUSE (NPI# 1669940599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669940599 |
| Entity Type | Organization |
| Organization Name | PORTERS HOUSE |
| Practice Address |
159 Edgewood Ave Waterbury CT 06706-2211 |
| Practice Telephone | 2035192222 |
| Mailing Telephone | 2035192222 |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-11-08 |
| Authorized Official Name | SARA WRENN (CLINICAL THERAPIST) |
| Authorized Official Telephone | 2035192222 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
159 EDGEWOOD AVE |
| City | WATERBURY |
| State | CT |
| Zip Code | 06706-2211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245750538 | Sameerah Ibtisam Rehmani | Internal Medicine | St Mary's Hospital, 56 Franklin Street, Waterbury, CT 06706 | 2017-06-27 |
| 1417208448 | Sherry L Gatling | Durable Medical Equipment & Medical Supplies | 394 Mill Street, 2nd Flr N, Waterbury, CT 06706 | 2012-10-01 |
| 1144505538 | Amanda Maria Delcavo | Physician Assistant | 50 Franklin Street, Waterbury, CT 06706 | 2011-10-17 |
| 1508097031 | Lauren K Ayr-volta | Clinical Neuropsychologist | 133 Scovill Street, Suite 211, Waterbury, CT 06706 | 2009-07-31 |
| 1538206800 | John Chardavoyne | Psychiatry & Neurology | Waterbury Outpatient Clinic, 95 Scovill Street, Waterbury, CT 06706 | 2007-01-30 |
| 1922111632 | Thomas Owen Genese | Internal Medicine | 56 Franklin Street, St. Mary's Hospital - Dept of Medicine, Waterbury, CT 06706 | 2006-08-16 |
| 1013942465 | Nancy Lou Kline | Nurse Practitioner | 133 Scovill Street-waterbury Va Community Based Clinic, #203, Waterbury, CT 06706 | 2006-07-12 |
| 1013455351 | Denisse Burgos-jimenez | Physician Assistant | 56 Franklin St, Waterbury, CT 06706 | 2017-02-07 |
| 1902255086 | Kaitlyn Jennings | Physician Assistant | 56 Franklin St, Waterbury, CT 06706 | 2016-06-08 |
| 1366823783 | Yamini Sachan | Internal Medicine | 56 Franklin Street, Waterbury, CT 06706 | 2015-06-11 |
| Find all providers in zip 06706 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568835015 | Family Services of Greater Waterbury | Clinic/Center | 35 Park Place, Waterbury, CT 06702-1215 | 2015-11-05 |
| 1093125064 | Family Services of Greater Waterbury | Clinic/Center | 14 Buckingham Street, Waterbury, CT 06710-1909 | 2014-04-30 |
| 1871505545 | Family Service of Greater Waterbury | Clinic/Center | 34 Murray St, Waterbury, CT 06710-1920 | 2006-08-12 |
| 1730729609 | Monarch Counseling Group, LLC | Clinic/Center | 32 Linden St, Waterbury, CT 06702-1301 | 2020-01-08 |
| 1346718921 | New Opportunities Inc. | Clinic/Center | 232 N Elm St, Waterbury, CT 06702-1516 | 2018-11-13 |
| 1700352721 | Connecticut Renaissance, Inc. | Clinic/Center | 527 Wolcott St, Waterbury, CT 06705-1240 | 2018-10-17 |
| 1962760561 | Wellmore, Inc | Clinic/Center | 402 East Main St, Waterbury Outpatient Behavioral Health Services, Waterbury, CT 06702-1701 | 2012-05-02 |
| 1669617973 | Connecticut Renaissance, Inc. | Clinic/Center | 70 Central Ave, Waterbury, CT 06702-1207 | 2008-12-16 |
| 1295980787 | Catholic Charities Inc - Archdiocese of Hartford | Clinic/Center | 13 Wolcott St, Waterbury, CT 06702-1727 | 2008-11-25 |
| 1780876078 | Waterbury Counseling Affiliates | Clinic/Center | 1078 W Main St, Waterbury, CT 06708 | 2007-08-10 |
| Find all providers in WATERBURY | ||||
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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.