Organization Active NPI

Rapha Behavioral Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • South Windsor, CT
National Provider Identifier
1487125456
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
RAPHA BEHAVIORAL SERVICES LLC
Practice address
925 Sullivan Ave Ste 2
South Windsor, CT 06074-2080
Phone
(860) 432-7771
NPI assigned
Dec 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

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

Authorized official

Name
William A Abrokwa, APNNPI 1205346335
Title
Sole Member
Phone
(860) 432-7771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

925 Sullivan Ave Ste 2
South Windsor, CT 06074-2080

Mailing address

925 Sullivan Ave Ste 2
South Windsor, CT 06074-2080
Phone (860) 432-7771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190226000159 CT Part B Supplier - Clinic/Group Practice 9537408208 Receives reassigned benefits from 1 practitioner
Practice locations: South Windsor, CT

National Provider Directory

National Provider Directory

Locations

5 Magauran Dr
Ste 1
Stafford Springs, CT 06076
Phone (860) 851-9086

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544918400000",
    "number": "1487125456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 SULLIVAN AVE STE 2",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742080",
            "telephone_number": "860-432-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SULLIVAN AVE STE 2",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742080",
            "telephone_number": "860-432-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAPHA BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A",
        "authorized_official_last_name": "ABROKWA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "860-432-7771",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.