Nancy Trevor

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Weatogue, CT

NPI 1962563403 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1962563403
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
001989 (CT)
Practice address
2 Brownstone Turn
Weatogue, CT 06089-9678
Phone
(860) 408-9171
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
001989CTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Center for Family Service and Mental Health, Inc. Past Accepting new patients
Medoptions Behavioral Health Assoc, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 001989 CT Yes

Addresses

Primary practice location

2 Brownstone Turn
Weatogue, CT 06089-9678

Mailing address

2 Brownstone Turn
Weatogue, CT 06089-9678
Phone (860) 408-9171

Other providers in Weatogue, CT

All providers in Weatogue, CT · Psychiatric/Mental Health Nurse Practitioner in Connecticut

Sources for this page

Verify at the official NPI Registry.