Psychological Health Center of Suffield, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

006144 Issued in CT

Legal business name

PSYCHOLOGICAL HEALTH CENTER OF SUFFIELD, LLC

Practice address

230B Mountain Rd
Lower Level
Suffield, CT 06078-2082

Phone

(860) 254-5991

NPI assigned

Oct 1, 2008

Organization subpart

No

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

Authorized official

Name

Shannon Lee Ayotte Stauffer, L.C.S.W.NPI 1720035041

Title

Owner

Phone

(860) 989-7875

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Shannon L. Ayotte Stauffer, L.C.S.W., L.L.C.

  • Clinical Social Worker
  • Simsbury, CT
  • NPI 1083636997

  O20060808000116

  Same enrollment

Locations

Practitioners 1

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

• Shannon Lee Ayotte Stauffer, L.C.S.W.

  • Clinical Social Worker
  • Suffield, CT
  • NPI 1720035041
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1104077759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 BURBANK AVE STE 2B",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060781459",
            "telephone_number": "860-989-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230B MOUNTAIN RD",
            "address_2": "LOWER LEVEL",
            "city": "SUFFIELD",
            "state": "CT",
            "postal_code": "060782082",
            "telephone_number": "860-254-5991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL HEALTH CENTER OF SUFFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-01",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "AYOTTE STAUFFER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-989-7875",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CT",
            "license": "006144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter L. Coombs, DMD, PC
• Eric J. Peters, PHD
• Ashley Petersen
• Alix Pierce, LPC
• Psychiatric Services of Suffield, LLC
• Quality Choice Homecare LLC
• Quality Choice Homecare LLC
• Susan Thompson Rafferty, ATC,L
• Giovanna Recchia
• Rhodium Care Group of CT PLLC

• Community/Behavioral Health Agency in Suffield, CT
• Providers in Suffield, CT by specialty
• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.