CONNECTICUT BEHAVIORAL HEALTH ASSOC, P.C.; NPI #1629158126

Contact Information

CONNECTICUT BEHAVIORAL HEALTH ASSOC, P.C.

41 FAIR HARBOUR PL
NEW LONDON, CT 06320-4710

Phone: 860-437-6914
Fax: 860-437-6920
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Clinical	103TC0700X	62	Psychologist, Clinical
Clinical	1041C0700X	80	Licensed Clinical Social Worker
Marriage & Family Therapist	106H00000X
Professional	101YP2500X
Psychiatric/Mental Health	363LP0808X	50	Nurse Practitioner
Psychiatry	2084P0800X	26	Physician/Psychiatry

Indicates primary specialty

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NPI Profile & details for CONNECTICUT BEHAVIORAL HEALTH ASSOC, P.C.

NPI # 1629158126

LBN Legal business name CONNECTICUT BEHAVIORAL HEALTH ASSOC, P.C.

Authorized official BASSAM AWWA - (MEDICAL DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/17/2006

Last updated 11/16/2015 - About 11 years ago

Identifiers

CT	Medicaid	004192324
CT	Medicaid	004195774
CT	Medicaid	004199271
CT	Medicaid	004255388
CT	Medicaid	004255411
CT	Medicaid	008008065

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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CONNECTICUT BEHAVIORAL HEALTH ASSOC, P.C.

Contact Information

Specialty

Mental Health (Including Community Mental Health Center)

Clinical

Clinical

Marriage & Family Therapist

Professional

Psychiatric/Mental Health

Psychiatry

NPI Profile & details for CONNECTICUT BEHAVIORAL HEALTH ASSOC, P.C.

Reviews for CONNECTICUT BEHAVIORAL HEALTH ASSOC, P.C.