Individual provider Active NPI

Victoria Oliver, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Bloomfield, CT
National Provider Identifier
1134848153
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
12.010810 Issued in CT
Practice address
3 Northwestern Dr
Bloomfield, CT 06002-3465
Phone
(860) 751-4570
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 12.010810 CT Primary

Addresses

Primary practice location

3 Northwestern Dr
Bloomfield, CT 06002-3465

Mailing address

250 Woodford Ave Apt 13
Plainville, CT 06062-2481
Phone (860) 751-4570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230705001777 CT Practitioner - Nurse Practitioner 6204295504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lswhb, LLCGroup PAC ID 9638414204, 21 clinicians

Practice addresses (Care Compare)

290 Western Blvd
Glastonbury, CT 06033-1236
Phone (860) 652-3325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10810CTMDPhysical Therapist
12.010810CTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infinity Mental Wellness PLLC Single Specialty CurrentSince Dec 6, 2022 Accepting new patients
Lswhb LLC Single Specialty CurrentSince Jun 5, 2023 Accepting new patients
Prohealth Physicians PC Single Specialty Past Accepting new patients

Locations

290 Western Blvd
Glastonbury, CT 06033
Phone (860) 652-3325

320 Western Blvd
Ste 104
Glastonbury, CT 06033
Phone (860) 633-2487

141 Willard Ave
Newington, CT 06111
Phone (860) 666-5601

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1134848153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 WOODFORD AVE APT 13",
            "city": "PLAINVILLE",
            "state": "CT",
            "postal_code": "060622481",
            "telephone_number": "860-751-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 NORTHWESTERN DR",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023465",
            "telephone_number": "860-751-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "VICTORIA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "12.010810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

Verify at the official NPI Registry.