PEAK LONGEVITY LLC NPI 1922596360

NPI Information

NPI: 1922596360
Provider Name: PEAK LONGEVITY LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
451 STATE ST
NORTH HAVEN, CT
ZIP 06473
Phone: (203) 281-4325
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PEAK LONGEVITY LLC is a mental health (including community mental health center) clinic center in North Haven, CT. PEAK LONGEVITY LLC NPI is 1922596360. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

451 STATE ST
NORTH HAVEN, CT
ZIP 06473-070
Phone: (203) 281-4325
Fax: (203) 281-4324

The provider's authorized official is Deborah Marcus, Lcsw .
The authorized official title is Director, Lcsw and has the following contact phone number (203) 281-4325.

The enumeration date for this NPI number is 4/30/2018 and was last updated on 4/30/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1041C0700X	Social Worker	Clinical	005904	CONNECTICUT	No
2	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	005904	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	140005904CT03	OTHER	CONNECTICUT	ANTHEM BCBS

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: 5/5/2024

NPI Synchronization or Removal

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