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GERICARE PSYCH LLC NPI 1467789602


NPI Information

NPI: 1467789602
Provider Name: GERICARE PSYCH LLC

Doing Business As: GERICARE PSYCH

Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

Address:
464 WOLCOTT RD
WOLCOTT, CT
ZIP 06716
Phone: (203) 633-4560
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GERICARE PSYCH LLC is a prescribing (medical) psychologist in Wolcott, CT. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. GERICARE PSYCH LLC NPI is 1467789602. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Gericare Psych.

The provider's business location address is:

464 WOLCOTT RD
WOLCOTT, CT
ZIP 06716-626
Phone: (203) 633-4560

The provider's authorized official is Jonathan Brenes .
The authorized official title is Ceo and has the following contact phone number (203) 633-4560.

The enumeration date for this NPI number is 11/9/2009 and was last updated on 11/9/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103T00000XPsychologistNo
2103TA0700XPsychologistAdult Development & AgingNo
3103TB0200XPsychologistCognitive & BehavioralNo
4103TC0700XPsychologistClinicalNo
5103TP0016XPsychologistPrescribing (Medical)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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