BEACON BEHAVIORAL SERVICES LLC (NPI# 1891872842) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891872842 |
| Entity Type | Organization |
| Organization Name | BEACON BEHAVIORAL SERVICES LLC |
| Practice Address |
40 Dale Road Suite 201 Avon CT 06000 |
| Mailing Address |
433 S Main St Ste 327 West Hartford CT 06110-2816 |
| Practice Telephone | 8606769350 |
| Practice Fax Number | 8606787178 |
| Mailing Telephone | 8606769350 |
| Mailing Fax Number | 8606787178 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-04-17 |
| Authorized Official Name | MS. JUDITH A KUILAN (BILLING) |
| Authorized Official Telephone | 8606769350 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BC & BS | 50BEACON8CT01 | 01 |
| Street Address |
40 DALE ROAD SUITE 201 |
| City | AVON |
| State | CT |
| Zip Code | 06000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205913340 | Wendy F Habelow | Psychologist | 40 Dale Road, Suite 201, Avon, CT 06001 | 2006-11-01 |
| 1962831545 | Meagan A Leduc | Psychologist | 40 Dale Road, Suite 201, Avon, CT 06001 | 2013-11-05 |
| 1881922326 | Jill D Shalan | Psychologist | 40 Dale Road, Suite 201, Avon, CT 06001 | 2009-11-20 |
| 1801065131 | Vicki J Strnatka Knapp | Psychologist | 40 Dale Road, Suite 201, Avon, CT 06001 | 2008-02-20 |
| 1669669982 | Dartmouth Endocrinology LLC | Internal Medicine | 40 Dale Road, Suite 202, Avon, CT 06001 | 2007-10-01 |
| 1699979542 | Elizabeth Ruel Matern | Pediatrics | 40 Dale Road, Suite 201, Avon, CT 06001 | 2007-06-13 |
| 1932311453 | Bruce Eliot Komarow | Dentist | 40 Dale Road, Avon, CT 06001 | 2007-05-04 |
| 1649321258 | Ryan D. Hartmann | Psychologist | 40 Dale Road, Suite 201, Avon, CT 06001 | 2007-01-12 |
| 1073670881 | Kimberlee J. Werrett | Social Worker | 40 Dale Road, Suite 201, Avon, CT 06001 | 2007-01-02 |
| 1780761726 | Heather Quinlan | Social Worker | 40 Dale Road, Suite 201, Avon, CT 06001 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255958021 | Naruhiko Saito | Dentist | N-5 W-2, Chuo-ku, Jr Tower Office Plaza Sapporo 8th Fl., Sapporo, HOKKAIDO 0600005 | 2020-06-28 |
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 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.