Wellmore, Inc

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

DPH 0436/0528 Issued in CT

Legal business name

WELLMORE, INC

Practice address

402 East Main St
Waterbury Outpatient Behavioral Health Services
Waterbury, CT 06702-1701

Phone

(203) 755-1143

Fax

(203) 753-3274

NPI assigned

May 2, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Gary M Steck, LMFT

Title

Chief Executive Officer

Phone

(203) 574-9000

Specialties & licenses 1

Addresses

Other identifiers 14

Other names 1

• Wellmore, Inc.-Waterbury OP Behavioral Health Services Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Wellmore, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Waterbury, CT
  • NPI 1336407915

  O20120828000409

  Same enrollment
• Wellmore, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Waterbury, CT
  • NPI 1841379013

  O20120828000409

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 9

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

• Marie Boyd-Carter

  • Clinical Social Worker
  • Waterbury, CT
  • NPI 1902524606
  NPD
• Raymond Gunn, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Waterbury, CT
  • NPI 1932618568
  NPD
• Ariel Ligowski, LCSW

  • Clinical Social Worker
  • Waterbury, CT
  • NPI 1326597485
  NPD
• Caitlin J.C. McAvoy, LCSW

  • Clinical Social Worker
  • Watertown, CT
  • NPI 1740686724
  NPD
• Melanie Mitchell, MS,BA,LPC

  • Professional Counselor
  • Torrington, CT
  • NPI 1215202437
  NPD
• Regan M Moriarty, MSW,BA,LCSW

  • Clinical Social Worker
  • Waterbury, CT
  • NPI 1669709135
  NPD
• Kathleen E Nugent, LPC,MA,BS

  • Professional Counselor
  • Waterbury, CT
  • NPI 1538419965
  NPD
• Elisabeth D Peralta, LADC,MSW,BSW,ASW

  • Addiction (Substance Use Disorder) Counselor
  • Waterbury, CT
  • NPI 1114313947
  NPD
• Arthur Joseph Roy, MS,BA,LPC

  • Professional Counselor
  • Waterbury, CT
  • NPI 1891060026
  NPD

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471910400000",
    "number": "1962760561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MAIN ST",
            "address_2": "4TH FLOOR ADMINISTRATION",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022310",
            "telephone_number": "203-574-9000",
            "fax_number": "203-574-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 EAST MAIN ST",
            "address_2": "WATERBURY OUTPATIENT BEHAVIORAL HEALTH SERVICES",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067021701",
            "telephone_number": "203-755-1143",
            "fax_number": "203-753-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMORE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2016-08-23",
        "status": "A",
        "authorized_official_last_name": "STECK",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "203-574-9000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "CT",
            "license": "DPH 0436/0528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH/OXFORD-FREEDOM HEALTH",
            "identifier": "GRP/FACILITY",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008040528",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS OF CT",
            "identifier": "GRP/FACILITY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-CONNECTICARE",
            "identifier": "GRP/FACILITY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "D339210",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-UNITED HEALTHCARE",
            "identifier": "GRP/FACILITY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN/MHN TRICARE NORTH",
            "identifier": "GRP/FACILITY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "GRP/FACILITY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM BEHAVIORAL HEALTH/UBH",
            "identifier": "GRP/FACILITY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPH-PSYCHIATRIC OUTPATIENT CLINIC FOR ADULTS",
            "identifier": "0528",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HEALTH  PLAN",
            "identifier": "7882859",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHYCT",
            "identifier": "GRP/FACILITY",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPH-FACILITY FOR THE CARE OR TREATMENT OF SUBSTANCE ABUSE OR DEPENDENT PERSONS",
            "identifier": "LICENSE NO. 0436",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "2266871",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellmore, Inc.-Waterbury OP Behavioral Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel Weinreb, APRN
• Shoshana Weinreb, SLP
• Ronald Bruce Weir, D.D.S.
• Jennifer Welborn, CASE MANAGER
• Wellmore, Inc
• Wellmore, Inc.
• Wellmore, Inc.
• Terry Beth Welsh, LCSW, MED
• West Haven Vamc
• West Main Dental Associates

• Mental Health Clinic/Center (Including Community Mental Health Center) in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.