MEDOP BEHAVIORAL HEALTH ASSOCIATES PC; NPI #1053360677

Contact Information

MEDOP BEHAVIORAL HEALTH ASSOCIATES PC

55 HATCHETTS HILL RD
OLD LYME, CT 06371-1534

Phone: 800-370-3651
Fax: 877-515-7147
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Neurology	2084N0400X	13	Physician/Neurology
Acute Care	363LA2100X	50	Nurse Practitioner
Adult Health	363LA2200X	50	Nurse Practitioner
Adult Health	364SA2200X	89	Certified Clinical Nurse Specialist
Clinical	103TC0700X	62	Psychologist, Clinical
Clinical	1041C0700X	80	Licensed Clinical Social Worker
Family	363LF0000X	50	Nurse Practitioner
Geriatric Psychiatry	2084P0805X	86	Physician/Neuropsychiatry
Medical	363AM0700X	97	Physician Assistant
Nurse Practitioner	363L00000X	50	Nurse Practitioner
Psychiatric/Mental Health	364SP0808X	89	Certified Clinical Nurse Specialist
Psychiatric/Mental Health, Adult	364SP0809X	89	Certified Clinical Nurse Specialist
Psychiatric/Mental Health, Geropsychiatric	364SP0813X	89	Certified Clinical Nurse Specialist
Psychiatry	2084P0800X	26	Physician/Psychiatry

Indicates primary specialty

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NPI Profile & details for MEDOP BEHAVIORAL HEALTH ASSOCIATES PC

NPI # 1053360677

LBN Legal business name MEDOP BEHAVIORAL HEALTH ASSOCIATES PC

Authorized official DONNA DOOLEY - (CHIEF FINANCIAL OFFICER)

Entity Organization

Organization subpart ¹ No

Enumeration date 05/09/2006

Last updated 07/21/2022 - About 4 years ago

Identifiers

CT	Medicaid	004262531-MD
CT	Medicaid	004266004-PHD
CT	Medicaid	004266020-NP

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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MEDOP BEHAVIORAL HEALTH ASSOCIATES PC

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NPI Profile & details for MEDOP BEHAVIORAL HEALTH ASSOCIATES PC

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