SERENITY BEHAVIORAL HEALTH LLC (NPI# 1851665186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851665186 |
| Entity Type | Organization |
| Organization Name | SERENITY BEHAVIORAL HEALTH LLC |
| Practice Address |
616 Gold Star Hwy Groton CT 06340-6221 |
| Practice Telephone | 8604490200 |
| Mailing Telephone | 8604490200 |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |
| Authorized Official Name | ANN ELISA WRATCHFORD (OWNER) |
| Authorized Official Telephone | 8604490200 |
| Authorized Official Credential | PMHNP-BC APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | INDIVIDUAL NPI | 1063598316 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376177899 | Serenity Behavioral Health LLC | Clinic/Center | 145 N Eagle Rd, Havertown, PA 19083-3418 | 2020-02-24 |
| 1023365624 | Serenity Behavioral Health LLC | Psychologist | 2303 Hollywood Blvd, Suite 12, Hollywood, FL 33020-6711 | 2012-08-14 |
| Street Address |
616 GOLD STAR HWY |
| City | GROTON |
| State | CT |
| Zip Code | 06340-6221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821198508 | Thomas Joseph Maciolek | Psychologist | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2006-09-23 |
| 1629395652 | Robin Marie Hennessey | Social Worker | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2010-04-30 |
| 1598997421 | Shoreline Counseling Group,llc | Clinic/Center | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2009-08-11 |
| 1518120419 | Julie Ann Liefeld | Marriage & Family Therapist | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2008-07-10 |
| 1316157100 | Karen Lee Parkinson | Social Worker | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2007-05-23 |
| 1336270040 | Kathy Ann Martinelli | Counselor | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2007-03-07 |
| 1477682334 | Evelyn Marie Bridges | Social Worker | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2007-03-05 |
| 1275674467 | James Michael Collins | Marriage & Family Therapist | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2007-02-09 |
| 1184778250 | F. Henry Doran | Counselor | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2007-01-23 |
| 1174688311 | Michael John Formica | Counselor | 616 Gold Star Hwy, Groton, CT 06340-6221 | 2006-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 163WP0808X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902415953 | Simmi S Narula | Registered Nurse | 1 Brenner Rd, Wilton, CT 06897-4701 | 2020-07-27 |
| 1356968887 | Heather Hogaboom | Registered Nurse | 139 Coe Rd, Wolcott, CT 06716-2513 | 2020-07-01 |
| 1144843616 | Michael Skolnick | Registered Nurse | West Grad Building, Institute of Living, 200 Retreat Ave, Hartford, CT 06102 | 2020-05-19 |
| 1174144539 | Barbara Joy Wetzel | Registered Nurse | 84 Donahue Rd, North Granby, CT 06060-1402 | 2020-04-27 |
| 1538790050 | Patrycja Olechniej | Registered Nurse | 90 S Main St Ste 202, Middletown, CT 06457-3649 | 2020-02-03 |
| 1669018123 | Megan Mary Kelly Gilman | Registered Nurse | 264 Church St, Guilford, CT 06437-2439 | 2019-11-20 |
| 1245875434 | Maryann Carter | Registered Nurse | 139 Newent Rd, Lisbon, CT 06351-2927 | 2019-11-12 |
| 1811531171 | Kathleen Mildred Humpage | Registered Nurse | 138 Wood Pond Rd, Glastonbury, CT 06033-3702 | 2019-10-30 |
| 1396398061 | Aprn4u LLC | Registered Nurse | 304 Main St Ste 401d, Farmington, CT 06032-2985 | 2019-07-22 |
| 1720543267 | Rebeca Davis-tellez | Registered Nurse | 29 Weantinock Dr, New Milford, CT 06776-3084 | 2019-02-08 |
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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.