PROF. MARY D MOLLER


Address: 374 Grand Ave, New Haven, CT 06513-3733
Phone: 2037777411

PROF. MARY D MOLLER (NPI# 1770582884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770582884
Entity Type Individual
Full Name PROF. MARY D MOLLER
Credential DNP, APRN, PMHCNS-BC
Practice Address 374 Grand Ave
New Haven
CT 06513-3733
Mailing Address 405 Stevenson Rd
New Haven
CT 06515-2471
Practice Telephone 2037777411
Mailing Telephone 2037475667
Enumeration Date 2005-07-20
Last Update Date 2010-08-20
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 364SP0809X Clinical Nurse Specialist
Specialization: Psych/Mental Health, Adult
004003 CT Physician Assistants & Advanced Practice Nursing Providers
N 364SP0809X Clinical Nurse Specialist
Specialization: Psych/Mental Health, Adult
AP30003075 WA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT APRN LICENSE 004003 01
WA ARNP LIC # AP30003075 01

Other Providers MARY MOLLER

NPI Name Taxonomy Address Enumeration
1972615219 Mary Paul Moller Counselor 1151 Hospital Way Bldg D, Pocatello, ID 83201-2763 2006-08-31

Office Location

Street Address 374 GRAND AVE
City NEW HAVEN
State CT
Zip Code 06513-3733

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528669181 Marisol Orth Nurse Practitioner 374 Grand Ave, New Haven, CT 06513-3733 2020-11-02
1851999874 Ornella S Merino Marriage & Family Therapist 374 Grand Ave, New Haven, CT 06513-3733 2020-10-12
1043855521 Joel Daniel Newman Bluman Family Medicine 374 Grand Ave, New Haven, CT 06513-3733 2019-11-08
1790215093 Brian Padilla Psychologist 374 Grand Ave, New Haven, CT 06513-3733 2017-06-19
1346792355 Quest Diagnostics LLC Clinical Medical Laboratory 374 Grand Ave, First Floor, New Haven, CT 06511 2016-10-26
1083078695 Kyle Elligers Family Medicine 374 Grand Ave, New Haven, CT 06513-3733 2016-04-09
1073970224 Kelly Elizabeth Gaffney Dietitian, Registered 374 Grand Ave, New Haven, CT 06513-3733 2016-01-19
1811353634 Lori Goeschel Dietitian, Registered 374 Grand Ave, New Haven, CT 06513-3733 2016-01-08
1720468317 Sandra Gisela Williams Student in an Organized Health Care Education/Training Program 374 Grand Ave, Fair Haven Clinic, New Haven, CT 06513-3733 2015-06-09
1538549910 Leonel Julian Lopez IIi Family Medicine 374 Grand Ave, New Haven, CT 06513 2015-06-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366906141 Edward Rivera Case Manager/Care Coordinator 458 Grand Ave., Suite 103, New Haven, CT 06513 2019-01-25
1134698442 Village of Angels Home Health Care LLC Respite Care 470 James Street, Suite 007, New Haven, CT 06513 2018-11-15
1609358068 Sarah Khalil Pharmacist 745 Foxon Road, East Haven, CT 06513 2018-09-02
1912358375 Domanice Poindexter Nurse Practitioner Caremore Health, 444 Foxon Rd, East Haven, CT 06513 2016-06-28
1568839876 My Fair Haven Pharmacy LLC Durable Medical Equipment & Medical Supplies 72 Grand Ave, New Haven, CT 06513 2015-08-24
1871979567 Sankofa Counseling LLC Community/Behavioral Health 64 Thompson St Ste A101, East Haven, CT 06513 2015-08-04
1578967287 Curtis Stewart Pharmacy Technician 661 Thompson Street, East Haven, CT 06513 2014-10-09
1548686322 Davis Group LLC Social Worker 30 Grand Ave, New Haven, CT 06513 2014-03-17
1124459615 James Lucas IIi Dietitian, Registered 167 Old Foxon Road, Unit 30b, New Haven, CT 06513 2013-12-09
1609206135 Spretha Kadavath Dentist 50 Grand Ave, New Haven, CT 06513 2013-11-19
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Taxonomy Information

Taxonomy Code 364SP0809X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Clinical Nurse Specialist
Specialization Psych/Mental Health, Adult

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1053626929 Madonna Kay Fasula Clinical Nurse Specialist 100 York St Ste 2j, New Haven, CT 06511-5664 2010-08-16
1265589881 Kristin Hale Clinical Nurse Specialist 19 Edwards St, New Haven, CT 06511-7313 2007-01-04
1932180718 Bernice Gayle Mckay Clinical Nurse Specialist 184 Liberty St, Yale Psychiatric Institute, New Haven, CT 06519-1625 2005-11-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1750777827 Janice P. Holmes Clinical Nurse Specialist 87 Georges Ln, Monroe, CT 06468-3138 2015-04-15
1336556513 Deborah S Greene Aprn LLC Clinical Nurse Specialist 760 Hopmeadow St, Box 813, Simsbury, CT 06070-2223 2014-07-19
1396900270 Annmarie Bernier Clinical Nurse Specialist 19 Nursery Dr, West Hartford, CT 06117-2737 2008-07-21
1003934282 Christopher E Allen Clinical Nurse Specialist 71 East Avenue, Ste F, Norwalk, CT 06851-4903 2007-03-27
1417085465 Mary F Scully Clinical Nurse Specialist 29 Shadow Ln, West Hartford, CT 06110-1641 2007-03-01
1609971696 Christopher John Kochis Clinical Nurse Specialist 998 Farmington Ave, Suite 123, West Hartford, CT 06107-2162 2006-09-14
1922022359 Susan M. James Clinical Nurse Specialist 147 Durham Rd, Oak Park, Madison, CT 06443-2675 2006-07-27
1508883588 Donna Humeston Hoskins Clinical Nurse Specialist 22 Upper Main St, Sharon, CT 06069-2083 2006-07-16
1013956366 Katherine M. Nichols Clinical Nurse Specialist 75 Swantown Hl, Stonington Institute, North Stonington, CT 06359-1022 2006-06-05
1811970551 Jacquelyn A Meyer Clinical Nurse Specialist 71 East Ave, Suite V, Norwalk, CT 06851-4903 2005-11-28
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Competitor

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City NEW HAVEN
Zip Code 06513

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Dataset Information

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.

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