Organization Active NPI

Pursuecare Connecticut PC

  • Psychiatry Physician
  • Middletown, CT
National Provider Identifier
1003443185
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PURSUECARE CONNECTICUT PC
Practice address
101 Centerpoint Dr Ste 105
Middletown, CT 06457-7568
Phone
(860) 317-5251
Fax
(860) 469-2766
NPI assigned
Mar 26, 2020
Reactivated
May 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Melissa King
Title
Authorized
Phone
(860) 322-6712

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Addiction Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083A0300X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Clinic/Center 261Q00000X
Adult Mental Health Clinic/Center 261QM0850X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X
Acute Care Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SA2100X

Addresses

Primary practice location

101 Centerpoint Dr Ste 105
Middletown, CT 06457-7568

Mailing address

101 Centerpoint Dr Ste 105
Middletown, CT 06457-7568
Phone (860) 317-5251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, PA, MA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20200519002517 CT Part B Supplier - Clinic/Group Practice 8224469606 Receives reassigned benefits from 15 practitioners
Practice locations: Middletown, CT
O20200616001212 PA Part B Supplier - Clinic/Group Practice 8224469606 Receives reassigned benefits from 8 practitioners
Practice locations: Allentown, PA; Bethlehem, PA; Harrisburg, PA
O20200618000968 MA Part B Supplier - Clinic/Group Practice 8224469606 Receives reassigned benefits from 3 practitioners
Practice locations: Boston, MA

National Provider Directory

National Provider Directory

Locations

101 Centerpoint Dr
Ste 221
Middletown, CT 06457

1000 White Horse Rd
Ste 502
Voorhees, NJ 08043
Phone (856) 627-9898

401 N 17th St
Ste 308
Allentown, PA 18104
Phone (610) 434-2776

35 E Elizabeth Ave
Ste 205
Bethlehem, PA 18018
Phone (610) 865-4228

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689638400000",
    "number": "1003443185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CENTERPOINT DR STE 105",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064577568",
            "telephone_number": "860-317-5251",
            "fax_number": "860-469-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CENTERPOINT DR STE 105",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064577568",
            "telephone_number": "860-317-5251",
            "fax_number": "860-469-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURSUECARE CONNECTICUT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "deactivation_date": "2023-04-26",
        "reactivation_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "AUTHORIZED",
        "authorized_official_telephone_number": "860-322-6712"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.