Magnolia Behavioral Health, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MAGNOLIA BEHAVIORAL HEALTH, LLC

Practice address

762 Boston Post Rd FL 2
Madison, CT 06443-3047

Phone

(203) 903-9728

Fax

(844) 440-2333

NPI assigned

Feb 7, 2021

Organization subpart

No

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

Authorized official

Name

Jessika Ducharme Brasseaux, APRN, PMHNP

Title

Owner

Phone

(203) 903-9797

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24606/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1612656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739232000000",
    "number": "1750973152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BREWERY ST UNIT 9138",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115954",
            "telephone_number": "203-903-9797",
            "fax_number": "844-440-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 BOSTON POST RD FL 2",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064433047",
            "telephone_number": "203-903-9728",
            "fax_number": "844-440-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-07",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A",
        "authorized_official_last_name": "BRASSEAUX",
        "authorized_official_first_name": "JESSIKA",
        "authorized_official_middle_name": "DUCHARME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-903-9797",
        "authorized_official_credential": "APRN, PMHNP"
    },
    "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": []
}

• Madison Optical
• Madison Pediatrics LLC
• Madison Radiology PC
• Madison Radiology, PC
• Madison Rehabilitation Center Inc
• Karel J. Malovany, D.D.S.
• Lisa Ann Mammano, MS RPT
• Nancy M Mann, LCSW
• Justin Louis Labella Marchese, MFT
• Owen Marica

• Psychiatric/Mental Health Nurse Practitioner in Madison, CT
• Providers in Madison, 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 Feb 11, 2025; 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.