NPIMap

Barbara J. Fasulo, LCSW, LLC

Organization Active NPI Community/Behavioral Health Agency · Rocky Hill, CT

NPI 1447916622 · NPPES record last updated Nov 14, 2021

Key facts

NPI
1447916622
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
BARBARA J. FASULO, LCSW, LLC
Practice address
2257 Silas Deane Hwy
Rocky Hill, CT 06067-2328
Phone
(860) 416-5288
NPI assigned
Nov 12, 2021
Organization subpart
No

Authorized official

Name
Barbara J. Fasulo, LCSW
Title
Owner
Phone
(860) 416-5288

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20211214000037 CT Part B Supplier - Clinic/Group Practice 9032509641 Receives reassigned benefits from 1 practitioner
Practice locations: Rocky Hill, CT

National Provider Directory

Locations

28 Shunpike Rd
Ste 5
Cromwell, CT 06416

2257 Silas Deane Hwy
Rocky Hill, CT 06067
Phone (860) 257-7448

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

2257 Silas Deane Hwy
Rocky Hill, CT 06067-2328

Mailing address

2257 Silas Deane Hwy
Rocky Hill, CT 06067-2328
Phone (860) 416-5288

Other providers in Rocky Hill, CT

All providers in Rocky Hill, CT · Community/Behavioral Health Agency in Connecticut

Sources for this page

Verify at the official NPI Registry.