Individual provider Active NPI

Renee Clunie, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Granby, CT
National Provider Identifier
1164249694
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
13878 Issued in CT
Practice address
83 Hartford Ave
Granby, CT 06035-2336
Phone
(860) 810-6799
NPI assigned
Sep 25, 2024
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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 Practitioner 363LP0808X 13878 CT Primary

Addresses

Primary practice location

83 Hartford Ave
Granby, CT 06035-2336

Mailing address

83 Hartford Ave
Granby, CT 06035-2336

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
I20250702003182 CT Practitioner - Nurse Practitioner 3870006729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Connecticut Behavioral Health LLCGroup PAC ID 1951692706, 8 clinicians

Practice addresses (Care Compare)

2257 Silas Deane Hwy
Suite 6
Rocky Hill, CT 06067-2328
Phone (860) 736-4140

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13878CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Connecticut Behavioral Health LLC Psychiatric/Mental Health CurrentSince Apr 1, 2025 Accepting new patients

Locations

2257 Silas Deane Hwy
Ste 6
Rocky Hill, CT 06067
Phone (860) 736-4140

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1164249694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 HARTFORD AVE",
            "city": "GRANBY",
            "state": "CT",
            "postal_code": "060352336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 HARTFORD AVE",
            "city": "GRANBY",
            "state": "CT",
            "postal_code": "060352336",
            "telephone_number": "860-810-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLUNIE",
        "first_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "13878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granby, CT

Sources for this page

Verify at the official NPI Registry.