Mentagen Advanced Behavioral Medicine, PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MENTAGEN ADVANCED BEHAVIORAL MEDICINE, PC

Practice address

74 New London Tpke
Suite 5
Glastonbury, CT 06033-4204

Phone

(860) 338-4864

NPI assigned

May 15, 2012

Organization subpart

No

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

Authorized official

Name

Mohammad Shamsi, MD

Title

Owner

Phone

(860) 338-4864

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1538428206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 NEW LONDON TPKE",
            "address_2": "SUITE 5",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334204",
            "telephone_number": "860-338-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 NEW LONDON TPKE",
            "address_2": "SUITE 5",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334204",
            "telephone_number": "860-338-4864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAGEN ADVANCED BEHAVIORAL MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "SHAMSI",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-338-4864",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Psychology Associates
• Meghan Butler PSYD LLC
• Vaibhav Mehendiratta, MD
• Amanda Meisterling, LMSW
• Ruby Mensah, PMHNP
• Margaret Ann Meskill, PSY.D.
• Danielle Messier, PT
• Ellen Metzger, MS, RD
• Melissa Kay Meyers, ATC
• Chelsey Micciche

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.