Shore Wellness CT

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SHORE WELLNESS CT

Practice address

85B Wall St
Madison, CT 06443-3121

Phone

(203) 896-0101

NPI assigned

Aug 23, 2017

Organization subpart

No

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

Authorized official

Name

Erica Baloga, LMFTNPI 1609158104

Title

Clinician

Phone

(203) 896-0101

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Erica Loren Baloga

  • Marriage & Family Therapist
  • Dayville, CT
  • NPI 1609158104
  NPD (past) Authorized official

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503446400000",
    "number": "1316464191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 PINE ST APT 315",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060408418",
            "telephone_number": "860-759-8346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85B WALL ST",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433121",
            "telephone_number": "203-896-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE WELLNESS CT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A",
        "authorized_official_last_name": "BALOGA",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "203-896-0101",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Seeley, M.S. CCC-SLP
• Kathryn Z Sejourne, LPC
• Serle M. Epstein M.D.
• Shari a. Roguski DC, LLC
• Ryan Shook, LCSW
• Shoreline Anesthesia Associates LLC
• Shoreline Chiropractic Center, LLC
• Shoreline Medical Associates LLC
• Shoreline Pediatrics & Adolescent Medicine, P.C.
• Shoreline Psychological

• Community/Behavioral Health Agency in Madison, CT
• Providers in Madison, CT by specialty
• Community/Behavioral Health Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.