PSYCHIATRIC MEDICINE CENTER, PC (NPI# 1740339589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740339589 |
| Entity Type | Organization |
| Organization Name | PSYCHIATRIC MEDICINE CENTER, PC |
| Practice Address |
501 Ocean Ave New London CT 06320-4521 |
| 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 | PAMELA GRAVES (CREDENTIALER) |
| Authorized Official Telephone | 8604426364 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1528116118 | Psychiatric Medicine Center, PC | Psychiatry & Neurology | 501 Ocean Ave, New London, CT 06320-4521 | 2007-01-08 |
| Street Address |
501 OCEAN AVE |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320-4521 |
| 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 |
| 1477602217 | Psychiatric Medicine Center PC | Psychiatry & Neurology | 501 Ocean Ave, Psychiatric Medicine Center PC, New London, CT 06320 | 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 | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003454166 | Seth Davis Utley | Counselor | 334 Pearl Bay Dr, New London, NC 28127-9128 | 2019-12-19 |
| 1952651432 | Tanya Wenke | Counselor | 255 Hempstead Street, New London, CT 06340 | 2012-09-12 |
| 1528297470 | Julie Feider, Mse, Lpc | Counselor | 401 W North Water St, New London, WI 54961-1249 | 2009-07-13 |
| 1861634719 | Rebecca L Kramer | Counselor | 315 Burton St, New London, WI 54961 | 2009-03-24 |
| 1073680252 | James Bernard Esposito | Counselor | 370 Main St., New London, NH 03257 | 2006-11-30 |
| 1891307716 | Dashelle Grant | Counselor | 7 Vauxhall St, New London, CT 06320-5711 | 2020-08-21 |
| 1639780943 | Jacqueline Paige Fiege | Counselor | E7475 Rawhide Rd, New London, WI 54961-9025 | 2020-08-11 |
| 1356964779 | Cassandra L Leuchner | Counselor | 7 Vauxhall St, New London, CT 06320-5711 | 2020-05-20 |
| 1730725938 | Candice Kreis | Counselor | E7475 Rawhide Rd, New London, WI 54961-9025 | 2019-11-22 |
| 1376187005 | Terry Stone-porreca | Counselor | 35 Newport Road, New London, NH 03257-5413 | 2019-11-06 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 06320 |
Please comment or provide details below to improve the information on PSYCHIATRIC MEDICINE CENTER, PC.
| 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.