Organization
MEDOPTIONS BEHAVIORAL HEALTH ASSOC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA DE GRAY (CREDENTIALING MNGR)
(800) 370-3651
Entity
Organization
Contact information
Practice address
20 RESEARCH PKWY, SUITE C, OLD SAYBROOK, CT 06475-4214
(800) 370-3651
(860) 510-0020
Mailing address
20 RESEARCH PKWY, SUITE C, OLD SAYBROOK, CT 06475-4214
(800) 370-3651
(860) 510-0020
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/07/2006
Last updated
05/26/2009
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