Psychiatric Health Associates, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3777 Issued in CT

Legal business name

PSYCHIATRIC HEALTH ASSOCIATES, LLC

Practice address

75 New Haven Ave
Milford, CT 06460-4854

Phone

(203) 693-2636

Fax

(203) 874-2965

NPI assigned

Jul 23, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Susan Boorin, PHD, APRN-BCNPI 1972867695

Title

Nurse Practitioner

Phone

(203) 693-2636

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 1

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

• Susan J Boorin, PHD, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Milford, CT
  • NPI 1972867695

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1407264351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 NEW HAVEN AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604854",
            "telephone_number": "203-693-2636",
            "fax_number": "203-874-2965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 NEW HAVEN AVE",
            "city": "MILFORD",
            "state": "CT",
            "postal_code": "064604854",
            "telephone_number": "203-693-2636",
            "fax_number": "203-874-2965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC HEALTH ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "BOORIN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "203-693-2636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, APRN-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "3777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8040766",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Milford, CT
• Providers in Milford, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.