Be Well Mental Health Services, LLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Westport, CT
NPI 1790330751 · NPPES record last updated Aug 7, 2019
Key facts
- NPI
- 1790330751
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- BE WELL MENTAL HEALTH SERVICES, LLC
- Practice address
- 840 Post Rd E
Westport, CT 06880-5236 - Phone
- (203) 429-4190
- NPI assigned
- Aug 7, 2019
- Organization subpart
- No
Authorized official
- Name
- Grace Cullen
- Title
- Medical Billing Manager
- Phone
- (203) 368-5515
Practitioners 1
-
Taylor Gaglia, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210322001186 | CT | Part B Supplier - Clinic/Group Practice | 3779990627 |
Receives reassigned benefits from 1 practitioner Practice locations: Westport, CT |
National Provider Directory
Locations
489 Post Rd E
Ste 202
Westport, CT 06880
Phone (203) 429-4190
840 Post Rd E
Westport, CT 06880
Phone (203) 429-4190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
840 Post Rd E
Westport, CT 06880-5236
Mailing address
840 Post Rd E
Westport, CT 06880-5236
Phone (203) 429-4190
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004069985 | Medicaid | CT |
Other providers in Westport, CT
- Heather B Bauer
- David H. Baum
- Michael Jose Bautista
- Bay Street Pediatrics Assoc.
- Bayada Home Health Care, Inc.
- Sarah Becker
- Justine Carol Bedocs
- Mark Beitel
- Alison Bellevue
- Maria Cristina Benedetto
All providers in Westport, CT · Psychiatric/Mental Health Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.