Mana Psychological Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MANA PSYCHOLOGICAL SERVICES LLC

Practice address

10 N Main St Ste 305
West Hartford, CT 06107-1901

Phone

(203) 240-7075

NPI assigned

Jan 7, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Samantha Anne Boutin, LPCNPI 1568007367

Title

Owner and LPC

Phone

(203) 240-7075

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Samantha Anne Boutin

  • Professional Counselor
  • West Hartford, CT
  • NPI 1568007367
  NPD Authorized official

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578355200000",
    "number": "1033759196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST STE 305",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071901",
            "telephone_number": "203-240-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST STE 305",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071901",
            "telephone_number": "203-240-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANA PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-07",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A",
        "authorized_official_last_name": "BOUTIN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER AND LPC",
        "authorized_official_telephone_number": "203-240-7075",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andres O Makarem, MD
• Shital Makati, PHARMACIST
• Bland Dew Maloney, MSW, LCSW
• Kelly Maloney, PA
• Sarah Malster, LPC
• George Mancini, COTA
• John E. Mancini,, LPC
• Matthew Maneggia, L.AC., D.A.
• Dara Manness
• Eyal David Maoz Halevy, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.