Suzanne Ellis Cleary, OT

Individual provider Active NPI Occupational Therapist · New Canaan, CT

NPI 1194265264 · NPPES record last updated Mar 8, 2017

Key facts

NPI
1194265264
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
001536 (CT)
Practice address
3 Farm Road
New Canaan, CT 06840-6698
Phone
(203) 594-5200
Fax
(203) 594-5412
NPI assigned
Mar 8, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Preferred Therapy Outpatient Services, LLC (9 clinicians)

Practice addresses (Care Compare)

3 Farm Rd
New Canaan, CT 06840-6626
Phone (203) 594-5340

850 Silas Deane Hwy
FL 2
Wethersfield, CT 06109-3440

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230207000829 CT Practitioner - Occupational Therapist in Private Practice 5092187724 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
001536CTMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Therapy Outpatient Services, LLC Occupational Therapist Current
since Nov 3, 2022
Accepting new patients
Preferred Therapy Outpatient Services, LLC Occupational Therapist Current
since Nov 3, 2022
Accepting new patients

Locations

3 Farm Rd
New Canaan, CT 06840
Phone (203) 594-5200

850 Silas Deane Hwy
Fl 2
Wethersfield, CT 06109
Phone (860) 610-0400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 001536 CT Yes

Addresses

Primary practice location

3 Farm Road
New Canaan, CT 06840-6698

Mailing address

3 Farm Road
New Canaan, CT 06840-6698
Phone (203) 594-5200

Other providers in New Canaan, CT

All providers in New Canaan, CT · Occupational Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.