TRACY CLOUGH, LCSW, LLC (NPI# 1992207690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992207690 |
| Entity Type | Organization |
| Organization Name | TRACY CLOUGH, LCSW, LLC |
| Practice Address |
515 Bridgeport Ave Journey To Wellness Suite Shelton CT 06484 |
| Mailing Address |
298 Park Ln Trumbull CT 06611-2254 |
| Practice Telephone | 2038148113 |
| Mailing Telephone | 9738094722 |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | TRACY CLOUGH (OWNER) |
| Authorized Official Telephone | 9738094722 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 010006 | CT | Agencies |
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
010006 | CT | Ambulatory Health Care Facilities |
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
010006 | CT | Ambulatory Health Care Facilities |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
010006 | CT | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 25 Water St, Guilford, CT 064372861 | 2038148113 |
| Street Address |
515 BRIDGEPORT AVE JOURNEY TO WELLNESS SUITE |
| City | SHELTON |
| State | CT |
| Zip Code | 06484 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083122550 | Tracy Clough | Social Worker | 515 Bridgeport Ave, Shelton, CT 06484-5366 | 2018-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949517 | Judy Ports | Speech-Language Pathologist | 100 Bear Sawmill Rd, Shelton, CT 06484 | 2020-07-22 |
| 1144793340 | Theodore N. Zengou | Pharmacist | 875 Bridgeport Av., Shelton, CT 06484 | 2019-01-10 |
| 1194215046 | Brightview Shelton LLC | Alzheimer Center (Dementia Center) | 30 Beard Sawmill Road, Shelton, CT 06484 | 2018-05-16 |
| 1477071264 | Emily Buccigross | Specialist/Technologist | 941 Constitution Blvd N, Shelton, CT 06484 | 2017-09-01 |
| 1134649643 | Margaret Grace Ferrara | Dentist | 4 Corporate Dr Ste 383, Shelton, CT 06484 | 2017-06-26 |
| 1376092007 | Qmg3 LLC | Family Medicine | 405 Bridgeport Avenue, Shelton, CT 06484 | 2016-09-22 |
| 1215316427 | Marcella N. Sancho, Lcsw, LLC | Social Worker | 4 Research Drive, Suite 402, Shelton, CT 06484 | 2015-05-20 |
| 1578987483 | Lisa Sych | Speech-Language Pathologist | 584 Long Hill Avenue- Bishop Wicke Health Center, Shelton, CT 06484 | 2014-02-12 |
| 1073936324 | Jeanne M. Kellogg | Occupational Therapy Assistant | 36 Fairlane Dr., Shelton, CT 06484 | 2014-01-22 |
| 1851724454 | Brittany Steiner | Behavioral Analyst | 26 Pound Ridge Ave, Shelton, CT 06484 | 2013-08-19 |
| Find all providers in zip 06484 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1356831960 | Connecticut Counseling Centers Inc | Clinic/Center | 15 Commerce Rd Lowr 1, Stamford, CT 06902-4553 | 2018-05-18 |
| 1780189480 | Connecticut Counseling Centers, Inc. | Clinic/Center | 290 Pratt St Ste 2312, Meriden, CT 06450-8600 | 2018-03-26 |
| 1750807426 | The Connection Inc | Clinic/Center | 37 Garden St, Hartford, CT 06105-2129 | 2017-08-15 |
| Find all providers with the same taxonomy | ||||
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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.