Eulah Lacey, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · New Haven, CT
NPI 1134735210 · NPPES record last updated Nov 17, 2023
Key facts
- NPI
- 1134735210
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 9258 (CT)
- Practice address
- 34 Park St
New Haven, CT 06519-1109 - Phone
- (203) 974-7000
- NPI assigned
- Sep 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201229000308 | CT | Practitioner - Nurse Practitioner | 3072926617 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9258 | CT | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornell Scott Hill Health Corporation | Current |
Accepting new patients | |
| Absolute Healthcare Solution | Psychiatric/Mental Health | Current | Accepting new patients |
| State of Connecticut | Current |
Accepting new patients | |
| State of Connecticut | Current |
Accepting new patients | |
| Prosperity Counseling LLC | Current |
Accepting new patients | |
| State of Connecticut | Current |
Accepting new patients | |
| Harvest Healthcare LLC | Current |
Accepting new patients |
Locations
21 Waterville Rd
Avon, CT 06001
Phone (860) 284-0182
1635 Central Ave
Bridgeport, CT 06610
Phone (203) 551-7464
165 Capitol Ave
Ste 2000
Hartford, CT 06106
450 Columbus Blvd
Ste 1001
Hartford, CT 06103
428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228
34 Park St
North Haven, CT 06519
Phone (203) 974-7417
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 9258 | CT | Yes |
Addresses
Primary practice location
34 Park St
New Haven, CT 06519-1109
Mailing address
34 Park St
New Haven, CT 06519-1109
Phone (203) 974-7000
Other providers in New Haven, CT
- Kelsey Rose Labella
- John Paul Labieniec
- Luiza Laborne Sousa Pinto Kalil
- Robert Labril
- Joann Graziella Lacerva-Hahn
- David Greg Lachowicz
- Michael Francis Lachowicz
- Jenna Lacolla
- Dana Lacroix
- Allison M Lacross
All providers in New Haven, CT · Psychiatric/Mental Health Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2023. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.