Vista Behavioral Health, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

046042 Issued in CT

Legal business name

VISTA BEHAVIORAL HEALTH, LLC

Practice address

152 Simsbury Rd
Building 9 2ND Floor
Avon, CT 06001-3777

Phone

(860) 269-3101

NPI assigned

Jun 2, 2008

Organization subpart

No

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

Authorized official

Name

Asante K Mendes, M.D.NPI 1114109212

Title

Medical Director

Phone

(860) 269-3101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 4

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

• Asante Kofi Mendes, M.D.

  • Psychiatry Physician
  • Farmington, CT
  • NPI 1114109212
  Medicare reassignment NPD Authorized official
• Verona Sonia Gordon

  • Psychiatric/Mental Health Nurse Practitioner
  • Wethersfield, CT
  • NPI 1164957809
  Medicare reassignment NPD
• Maria G Gaer, APRN-BC

  • Nurse Practitioner
  • Avon, CT
  • NPI 1700106176
  NPD (past)
• Laurie Bowman Mucciacciaro, LCSW

  • Clinical Social Worker
  • Avon, CT
  • NPI 1760805808
  NPD (past)

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1225297690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 SIMSBURY RD",
            "address_2": "BUILDING 9 2ND FLOOR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013777",
            "telephone_number": "860-269-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 SIMSBURY RD",
            "address_2": "BUILDING 9 2ND FLOOR",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013777",
            "telephone_number": "860-269-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "MENDES",
        "authorized_official_first_name": "ASANTE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "860-269-3101",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "046042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose M Vargas, PA-C
• Silvina Vazquez Varela, SLP
• Julie Ann Vernon, M.D.
• Jeannie Frances Lariosa Villamante, RPT, DPT
• Jennifer A Violette, PA-C
• Lauren Vo, APRN
• Traci Lynn Voss, PA
• Indira Vugdalic, PHARMD
• Truc Vuu
• Lisa-Brit Wahlberg, M.S, L.M.F.T.

• Psychiatry Physician in Avon, CT
• Providers in Avon, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; 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.