WANDEMBERGH MENTAL HEALTH SERVICES, LLC (NPI# 1003071275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003071275 |
| Entity Type | Organization |
| Organization Name | WANDEMBERGH MENTAL HEALTH SERVICES, LLC |
| Practice Address |
206 Wells St Manchester CT 06040-6152 |
| Practice Telephone | 8606435387 |
| Practice Fax Number | 8606435387 |
| Mailing Telephone | 8606435387 |
| Mailing Fax Number | 8606435387 |
| Enumeration Date | 2008-07-27 |
| Last Update Date | 2008-07-27 |
| Authorized Official Name | DR. HECTOR CHANES (CLINICAL PSYCHOLOGIST / PRESIDENT) |
| Authorized Official Telephone | 8606435387 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
002846 | CT | Behavioral Health & Social Service Providers |
| Street Address |
206 WELLS ST |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-6152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710501333 | Mackenzie Lawler | Social Worker | 200 W. Center Street, Suite C-2-6, Manchester, CT 06040 | 2020-05-29 |
| 1386288009 | Monica Diaz | Social Worker | 117 East Center Street, Suite A1, Manchester, CT 06040 | 2019-11-06 |
| 1346881596 | Sheryl Andrine Henry | Technician | 185 Pine Street, Apt 014, Manchester, CT 06040 | 2019-09-30 |
| 1811550304 | Edward Wahn Lee | Student in an Organized Health Care Education/Training Program | 130 Hartford Road, Manchester, CT 06040 | 2019-04-19 |
| 1538689534 | Bernard Ashirifie | Counselor | 869 Main Street, Apt 3, Manchester, CT 06040 | 2017-06-21 |
| 1497275697 | Justin David Chung | Dentist | 483 Middle Tpke W Ste 209, Manchester, CT 06040 | 2017-06-20 |
| 1114473436 | Amanda Edgar | Counselor | 469 Center Street, Manchester, CT 06040 | 2016-08-28 |
| 1760831366 | Samantha Micael | Marriage & Family Therapist | 200 West Center Street, Suite C-2-6, Manchester, CT 06040 | 2016-06-06 |
| 1962856179 | Odelia Brew | Nurse Practitioner | 256 Hackmatack Street, Manchester, CT 06040 | 2016-04-14 |
| 1306217765 | Stephen R Machattie | Social Worker | 843 Main St Ste 11, Manchester, CT 06040 | 2015-10-12 |
| Find all providers in zip 06040 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245552066 | Frederick Neff | Psychologist | 15 Woodholm Rd, Manchester, MA 01944-1041 | 2010-02-21 |
| 1417281064 | Shannon Jackson | Psychologist | 150 North Main St, Echn Health Services, Manchester, CT 06040-4188 | 2009-09-30 |
| 1871730390 | Scott Jerauld Adams | Psychologist | 250 Commercial St Ste 3004, Manchester, NH 03101 | 2009-01-21 |
| 1881851939 | David G. Kamen, Ph.d., P.C. | Psychologist | 23 W Webster St, Manchester, NH 03104-2913 | 2008-05-16 |
| 1093907917 | Steven Bonanno | Psychologist | 241 New State Rd Apt F, Manchester, CT 06042-7937 | 2007-08-14 |
| 1376753814 | Stephanie P. Morgan | Psychologist | 3 Ledgewood Cir, Manchester, MA 01944-1261 | 2007-05-23 |
| 1902952765 | Heidie Vazquez-garcia | Psychologist | 3855 Main St, Manchester, VT 05254 | 2007-01-26 |
| 1811082381 | Laurie C Geck | Psychologist | 1555 Elm Street, Manchester, NH 03101-1203 | 2006-10-03 |
| 1386740744 | Calvin R. Genzel | Psychologist | Pastoral Counseling Services, 2013 Elm Street, Manchester, NH 03104 | 2006-09-15 |
| 1316041700 | David G Kamen | Psychologist | 25 Lowell St Ste 502, Manchester, NH 03101-1647 | 2006-09-07 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 06040 |
Please comment or provide details below to improve the information on WANDEMBERGH MENTAL HEALTH SERVICES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.