Organization Active NPI

Modern Behavioral & Mental Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomfield, CT
National Provider Identifier
1033918404
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
MODERN BEHAVIORAL & MENTAL HEALTH SERVICES LLC
Practice address
116 Cottage Grove Rd Ste 110
Bloomfield, CT 06002-3200
Phone
(612) 481-7636
NPI assigned
Mar 10, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Oluchi NwokochaNPI 1841530748
Title
Owner
Phone
(612) 481-7636

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

116 Cottage Grove Rd Ste 110
Bloomfield, CT 06002-3200

Mailing address

2389 Main St Ste 100
Glastonbury, CT 06033-4617

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1033918404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2389 MAIN ST STE 100",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 COTTAGE GROVE RD STE 110",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023200",
            "telephone_number": "612-481-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN BEHAVIORAL & MENTAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "NWOKOCHA",
        "authorized_official_first_name": "OLUCHI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-481-7636"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.