WELLMORE, INC (NPI# 1962760561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962760561 |
| Entity Type | Organization |
| Organization Name | WELLMORE, INC |
| Other Organization Name | WELLMORE, INC.-WATERBURY OP BEHAVIORAL HEALTH SERVICES |
| Practice Address |
402 East Main St Waterbury Outpatient Behavioral Health Services Waterbury CT 06702-1701 |
| Mailing Address |
141 E Main St 4th Floor Administration Waterbury CT 06702-2310 |
| Practice Telephone | 2037551143 |
| Practice Fax Number | 2037533274 |
| Mailing Telephone | 2035749000 |
| Mailing Fax Number | 2035749006 |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2016-08-23 |
| Authorized Official Name | MR. GARY M STECK (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2035749000 |
| Authorized Official Credential | LMFT |
| 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) |
DPH 0436/0528 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | CIGNA BEHAVIORAL HEALTH | 2266871 | 01 |
| CT | UBH-CONNECTICARE | GRP/FACILITY | 01 |
| CT | DPH-PSYCHIATRIC OUTPATIENT CLINIC FOR ADULTS | 0528 | 01 |
| CT | UNITED BEHAVIORAL HEALTH | GRP/FACILITY | 01 |
| CT | UBH-UNITED HEALTHCARE | GRP/FACILITY | 01 |
| CT | DPH-FACILITY FOR THE CARE OR TREATMENT OF SUBSTANCE ABUSE OR DEP | LICENSE NO. 0436 | 01 |
| CT | 008040528 | 05 | |
| CT | ANTHEM BCBS OF CT | GRP/FACILITY | 01 |
| CT | HEALTHYCT | GRP/FACILITY | 01 |
| CT | MHN/MHN TRICARE NORTH | GRP/FACILITY | 01 |
| CT | UBH/OXFORD-FREEDOM HEALTH | GRP/FACILITY | 01 |
| CT | BEACON HEALTH STRATEGIES | D339210 | 01 |
| CT | AETNA HEALTH PLAN | 7882859 | 01 |
| CT | OPTUM BEHAVIORAL HEALTH/UBH | GRP/FACILITY | 01 |
| Other Name | Type Code |
|---|---|
| Wellmore, Inc.-Waterbury OP Behavioral Health Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336407915 | Wellmore, Inc | Clinic/Center | 142 Griggs St, Waterbury, CT 06704-3110 | 2012-05-02 |
| Street Address |
402 EAST MAIN ST WATERBURY OUTPATIENT BEHAVIORAL HEALTH SERVICES |
| City | WATERBURY |
| State | CT |
| Zip Code | 06702-1701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447464763 | Elsa J. Jimenez-francis | Marriage & Family Therapist | 402 East Main St, Wellmore Behavioral Health - Bsf, Waterbury, CT 06702-1701 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780120295 | Melitza Velez | Counselor | 80 Prospect St., Waterbury, CT 06702 | 2017-01-09 |
| 1467813600 | Ashley Joseph | Counselor | 30 Holmes Ave, Waterbury, CT 06702 | 2016-03-16 |
| 1649662313 | Lori Arens | Social Worker | 141 E Main St Fl 4, Waterbury, CT 06702 | 2015-03-04 |
| 1265725584 | Zelda Shleifer | Audiologist | 21 W Main St Fl Place-3, Waterbury, CT 06702 | 2011-05-19 |
| 1700024585 | Charlene Angela Jurgaitis | Durable Medical Equipment & Medical Supplies | 102 Grand Street, Waterbury, CT 06702 | 2009-02-02 |
| 1518090570 | Nathan Z Imre | Pharmacist | 161 East Main St Central Pharmacy, Waterbury, CT 06702 | 2007-03-13 |
| 1922149467 | Rachael A Petitti | Social Worker | 402 East Main Street, Waterbury, CT 06702 | 2007-02-09 |
| 1710024484 | Abbot Terrace Health Center | Assisted Living Facility | 44 Abbott Terrace, Waterbury, CT 06702 | 2007-01-31 |
| 1205994555 | Michael Arcangel Padilla | Social Worker | Western Connecticut Mental Health Network, 55 West Main Street Suite 410, Waterbury, CT 06702 | 2006-12-05 |
| 1205902723 | Colette M Anderson | Social Worker | 55 West Main St Suite 410, Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-27 |
| Find all providers in zip 06702 | ||||
| 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 |
|---|---|---|---|---|
| 1669940599 | Porters House | Clinic/Center | 159 Edgewood Ave, Waterbury, CT 06706-2211 | 2018-11-08 |
| 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 |
| 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.