PEAK LONGEVITY LLC (NPI# 1922596360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922596360 |
| Entity Type | Organization |
| Organization Name | PEAK LONGEVITY LLC |
| Practice Address |
451 State St North Haven CT 06473-3070 |
| Practice Telephone | 2032814325 |
| Practice Fax Number | 2032814324 |
| Mailing Telephone | 2032814325 |
| Mailing Fax Number | 2032814324 |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |
| Authorized Official Name | DEBORAH MARCUS, LCSW (DIRECTOR, LCSW) |
| Authorized Official Telephone | 2032814325 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
005904 | CT | Behavioral Health & Social Service Providers |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
005904 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | ANTHEM BCBS | 140005904CT03 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Peak Longevity LLC | 3231 11th St., Boulder, CO 80304 |
| Street Address |
451 STATE ST |
| City | NORTH HAVEN |
| State | CT |
| Zip Code | 06473-3070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720048150 | Liesel L. Gould | Pediatrics | 451 State St, North Haven, CT 06473-3019 | 2006-03-28 |
| 1699248047 | Marissa Butler | Counselor | 451 State St, North Haven, CT 06473-3070 | 2019-01-08 |
| 1922595560 | Kerry-ann Frank, Lcsw, LLC | Community/Behavioral Health | 451 State St, North Haven, CT 06473-3070 | 2018-04-19 |
| 1366964173 | Margaret Martin Shea | Nurse Practitioner | 451 State St, North Haven, CT 06473-3070 | 2017-07-13 |
| 1023465093 | Renee Cifarelli | Social Worker | 451 State St, North Haven, CT 06473-3070 | 2016-05-19 |
| 1164808226 | Ursula.l.chock-harris,lcsw, P.C. | Clinic/Center | 451 State St, North Haven, CT 06473-3070 | 2015-07-30 |
| 1619368677 | Madeleine Fejos | Social Worker | 451 State St, North Haven, CT 06473 | 2015-02-12 |
| 1720479025 | Ethan Parker | Counselor | 451 State St, North Haven, CT 06473-3070 | 2015-02-09 |
| 1659781383 | John Ramirez | Pediatrics | 451 State St, North Haven, CT 06473-3070 | 2014-05-02 |
| 1871731927 | Complete Pediatrics | Nurse Practitioner | 451 State St, North Haven, CT 06473-3019 | 2009-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043823347 | Yunmin Chen | Nurse Practitioner | 269 Spring Rd, North Haven, CT 06473 | 2020-08-26 |
| 1467944884 | Julian Cano | Acupuncturist | 444b Washington Ave, North Haven, CT 06473 | 2018-06-01 |
| 1487195848 | Wigtowne | Durable Medical Equipment & Medical Supplies | 117 Washington Ave., North Haven Shopping Cntr, North Haven, CT 06473 | 2017-03-17 |
| 1528415205 | Laura Michelle Delucia | Social Worker | 451 State St., North Haven, CT 06473 | 2016-05-23 |
| 1356702153 | Technical Gas Products, Inc. | Durable Medical Equipment & Medical Supplies | 1510 Canton Center Dr, Baltimore, MD 06473 | 2016-03-08 |
| 1043600687 | John Maltagliati | Pharmacy Technician | 200 Universal Dr. North, North Haven, CT 06473 | 2015-02-04 |
| 1184025603 | Hollyann C Mcnabola | Social Worker | 130 Washington Avenue, Upper Level, North Haven, CT 06473 | 2014-09-16 |
| 1194136648 | Carol Hogan | Speech-Language Pathologist | 54 Potter Rd, North Haven, CT 06473 | 2014-05-17 |
| 1376961946 | Jared R Langerman | Otolaryngology | 31 Broadway Fl 2, North Haven, CT 06473 | 2014-04-01 |
| 1396174280 | Azeez O Oladejo | Pharmacist | 2 Universal Drive North, North Haven, CT 06473 | 2013-11-01 |
| Find all providers in zip 06473 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891271201 | Leigh Forte Lpc | Clinic/Center | 410 State St Rm 2, North Haven, CT 06473-3149 | 2018-07-18 |
| 1164513388 | Town of North Haven Community Services | Clinic/Center | 5 Linsley Street, North Haven, CT 06473-2599 | 2006-09-27 |
| 1164808226 | Ursula.l.chock-harris,lcsw, P.C. | Clinic/Center | 451 State St, North Haven, CT 06473-3070 | 2015-07-30 |
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| 1760093108 | Intuitive Healing Counseling LLC | Clinic/Center | 95 Armory Rd Ste 2, Stratford, CT 06614-1753 | 2020-08-10 |
| 1750992244 | Connecting The Pieces, LLC | Clinic/Center | 151 New Park Ave Unit 27, Hartford, CT 06106-2181 | 2020-08-10 |
| 1063021228 | Clear Sky Therapy Services | Clinic/Center | 68 Lyman Rd, West Hartford, CT 06117-1311 | 2020-07-23 |
| 1104453562 | Empower Therapy & Wellness LLC | Clinic/Center | 786 Boston Post Rd # 203, Madison, CT 06443-3036 | 2020-03-25 |
| 1386279453 | Pathways To Wellness, LLC | Clinic/Center | 74 Sheldon Ter, New Haven, CT 06511-2006 | 2020-03-09 |
| 1053945196 | Farley Counseling Services | Clinic/Center | 29b Hartford Ave, Granby, CT 06035-2326 | 2020-02-27 |
| 1922630557 | Starfish Family Connections, LLC | Clinic/Center | 1367 Hanover Ave Apt 602, Meriden, CT 06451-6278 | 2020-02-11 |
| Find all providers with the same taxonomy | ||||
| City | NORTH HAVEN |
| Zip Code | 06473 |
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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.