Inside Out Wellness LLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · East Lyme, CT
NPI 1902647019 · NPPES record last updated Jun 9, 2024
Key facts
- NPI
- 1902647019
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- INSIDE OUT WELLNESS LLC
- Practice address
- 11 Heritage Rd
East Lyme, CT 06333-1107 - Phone
- (860) 886-3955
- NPI assigned
- Jun 3, 2024
- Organization subpart
- No
Authorized official
- Name
- Elizabeth Czikowsky, DNP, APRN
- Title
- Owner
- Phone
- (860) 886-3955
Practitioners 1
-
Elizabeth Czikowsky, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250709000346 | CT | Part B Supplier - Clinic/Group Practice | 2062926306 |
Receives reassigned benefits from 1 practitioner Practice locations: East Lyme, CT |
National Provider Directory
Locations
315 Flanders Rd
East Lyme, CT 06333
Phone (860) 235-5532
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Yes |
Addresses
Primary practice location
11 Heritage Rd
East Lyme, CT 06333-1107
Mailing address
11 Heritage Rd
East Lyme, CT 06333-1107
Other providers in East Lyme, CT
- Arlene Havens
- Healthsource of East Lyme LLC
- Patricia Healy
- Elizabeth Henry
- Hong Qi Acupuncture and Wellness Center
- Mary Jeanbyk
- Kim John Kaiser
- Archana Karanki
- Kathleen Corcoran Karlberg
- Daniel W Kerzner
All providers in East Lyme, 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 Jun 9, 2024. 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.