Staywell Stress Management LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006773 Issued in CT

Legal business name

STAYWELL STRESS MANAGEMENT LLC

Practice address

129 Samson Rock Dr
Unit B
Madison, CT 06443-3034

Phone

(203) 915-3777

Fax

(203) 909-6621

NPI assigned

Dec 5, 2009

Organization subpart

No

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

Authorized official

Name

Monica L. Cretella, LCSW

Title

Director

Phone

(203) 915-3777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Charles C Dike, MD

  • Psychiatry Physician
  • Middletown, CT
  • NPI 1811056054
  NPD (past)

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

{
    "created_epoch": "1259971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477353600000",
    "number": "1720316581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 REDCOAT LN",
            "city": "GUILFORD",
            "state": "CT",
            "postal_code": "064371946",
            "telephone_number": "203-915-3777",
            "fax_number": "203-909-6621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 SAMSON ROCK DR",
            "address_2": "UNIT B",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433034",
            "telephone_number": "203-915-3777",
            "fax_number": "203-909-6621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAYWELL STRESS MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-05",
        "last_updated": "2016-10-25",
        "status": "A",
        "authorized_official_last_name": "CRETELLA",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "203-915-3777",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174768105",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern CT Christian Network
• Madison Sparago
• Speech of Madison, LLC
• Claire Abigail Spinks, COTA
• Erin S. Springhorn, M.D.
• Lori C Stetz, M.D.
• Judith Coursen Stevens, LCSW
• Elizabeth M Strazar, MA, LPC
• Leslie E Sude, MD
• Sunshine Wellness LLC

• Clinical Social Worker in Madison, CT
• Providers in Madison, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2016; 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.