# MODERN BEHAVIORAL & MENTAL HEALTH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033918404
- **Authorized official:** OLUCHI NWOKOCHA (OWNER)
- **Authorized official phone:** (612) 481-7636

## Contact information

- **Practice address:** 116 COTTAGE GROVE RD STE 110, BLOOMFIELD, CT 06002-3200
- **Practice address phone:** (612) 481-7636
- **Mailing address:** 2389 MAIN ST STE 100, GLASTONBURY, CT 06033-4617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/10/2025
- **Last updated:** 03/10/2025