HEALTHDRIVE BEHAVIORAL HEALTH SERVICES, PLLC (NPI# 1760909279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760909279 |
Entity Type | Organization |
Organization Name | HEALTHDRIVE BEHAVIORAL HEALTH SERVICES, PLLC |
Practice Address |
101 Centerpoint Dr Ste 215 Middletown CT 06457-7568 |
Mailing Address |
100 Crossing Blvd Suite 300 Framingham MA 01702-5555 |
Practice Telephone | 8889646681 |
Practice Fax Number | 8886620859 |
Mailing Telephone | 6179646681 |
Mailing Fax Number | 3396862561 |
Enumeration Date | 2017-08-25 |
Last Update Date | 2019-12-31 |
Authorized Official Name | RICARDO A MUJICA (PRESIDENT) |
Authorized Official Telephone | 4135921980 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
Y | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians |
Street Address |
101 CENTERPOINT DR STE 215 |
City | MIDDLETOWN |
State | CT |
Zip Code | 06457-7568 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679504161 | Jeffrey L. Morer, Od, PC | Optometrist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2006-07-05 |
1790278828 | Madison Stevens | Dental Hygienist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2018-06-13 |
1063670016 | Michael D A Cicero | Podiatrist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2008-05-27 |
1316136831 | Healthdrive Audiology Group, PC | Audiologist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2007-10-22 |
1225227747 | Healthdrive Audiology Group, PC | Audiologist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2007-10-22 |
1225229271 | Mobile Audiology Associates, P.C. | Hearing Instrument Specialist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2007-08-06 |
1134310188 | Healthdrive Podiatry Group, PC | Prosthetic/Orthotic Supplier | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2007-08-06 |
1679789192 | Josana Joseph | Podiatrist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2007-05-14 |
1760590608 | Jeffrey L. Morer, Od, PC | Technician/Technologist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2006-08-29 |
1851409791 | Alec H. Jaret, Dmd, PC | Dental Hygienist | 101 Centerpoint Dr Ste 215, Middletown, CT 06457-7568 | 2006-08-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
Find all providers in zip 06457 |
Taxonomy Code | 2084P0805X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Geriatric Psychiatry |
Geriatric Psychiatry is a subspecialty with psychiatric expertise in prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly, and improvement of psychiatric care for healthy and ill elderly patients. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174565253 | Raveen Mehendru | Psychiatry & Neurology | Hartford Hospital Geriatric Psychiatry, 200 Retreat Avenue, Hartford, CT 06106 | 2006-06-12 |
1366428831 | Javier Salabarria | Psychiatry & Neurology | 67 Masonic Ave, Wallingford, CT 06492-3095 | 2005-12-16 |
1568014728 | Step Up Behavioral Care PC LLC | Psychiatry & Neurology | 111 Westcott Rd, Danielson, CT 06239-2929 | 2019-07-09 |
1407375363 | Connecticut Geriatric Neuropsychiatry, LLC | Psychiatry & Neurology | 558 Hopmeadow St, Simsbury, CT 06070-2415 | 2017-09-12 |
1457641805 | Unique Approach, LLC | Psychiatry & Neurology | 464 Wolcott Rd, Attn: Jonathan Brenes, Wolcott, CT 06716-2626 | 2011-04-19 |
1801186846 | Brandon Yarns | Psychiatry & Neurology | 300 George St Ste 901, New Haven, CT 06511-6662 | 2011-04-11 |
1275769549 | Isis Burgos-chapman | Psychiatry & Neurology | 400 Columbus Ave, New Haven, CT 06519-1233 | 2009-06-01 |
1225219108 | Shragit Glazman | Psychiatry & Neurology | 55 Hatchetts Hill Rd, Old Lyme, CT 06371 | 2007-11-19 |
1487710141 | Naomi Marta Mendelovicz | Psychiatry & Neurology | 365 Montauk Ave, New London, CT 06320-4700 | 2006-12-28 |
1720154198 | Subbarao Bollepalli | Psychiatry & Neurology | 97 Barnes Rd, Suite #2, Wallingford, CT 06492-1885 | 2006-11-28 |
Find all providers with the same taxonomy |
City | MIDDLETOWN |
Zip Code | 06457 |
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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.