Central Connecticut Behavioral Health LLC
Organization Active NPI Addiction Psychiatry Physician · Rocky Hill, CT
NPI 1043666480 · NPPES record last updated Apr 15, 2025
Key facts
- NPI
- 1043666480
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Addiction Psychiatry Physician 2084P0802X
- Legal business name
- CENTRAL CONNECTICUT BEHAVIORAL HEALTH LLC
- Practice address
- 2275 Silas Deane Hwy
Rocky Hill, CT 06067-2329 - Phone
- (860) 736-4139
- NPI assigned
- May 4, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Richard Frank Comshaw II, PHD APRN
- Title
- Chief Executive Officer
- Phone
- (860) 736-4139
Practitioners 10
-
Renee Clunie, APRN
-
Lynda S. Emard, APRN
-
Edith Hergan, M.D.
-
Liane J Leedom, M.D.
-
Jewel Walters-Davis, MSN, APRN, PMHNP-BC
-
Mohammad Farooq Dada, M.D.
-
Sanh Angkhavong, PMHNP-BC
-
Juleen Mason, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160624001721 | CT | Part B Supplier - Clinic/Group Practice | 1951692706 |
Receives reassigned benefits from 10 practitioners Practice locations: Rocky Hill, CT |
National Provider Directory
Locations
2257 Silas Deane Hwy
Ste 6
Rocky Hill, CT 06067
Phone (860) 736-4140
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Psychiatry Physician |
2084P0802X | Yes |
Addresses
Primary practice location
2275 Silas Deane Hwy
Rocky Hill, CT 06067-2329
Mailing address
238 Congdon St E
Middletown, CT 06457-2063
Phone (860) 736-4139
Other providers in Rocky Hill, CT
- Stefani Catenzaro
- Jeffrey Thomas Cavalieri
- Jennifer Cavallaro
- Centered Healing
- Centerwell Certified Healthcare Corp.
- Central Connecticut Health District
- Central Connecticut Health District
- Central CT Anxiety Ocd Treatment LLC
- Filomena Chamberland
- Ashley Chambrello
All providers in Rocky Hill, CT · Addiction Psychiatry Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.