Organization
BE WELL MENTAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE CULLEN (MEDICAL BILLING MANAGER)
(203) 368-5515
Entity
Organization
Contact information
Practice address
840 POST RD E, WESTPORT, CT 06880-5236
(203) 429-4190
Mailing address
840 POST RD E, WESTPORT, CT 06880-5236
(203) 429-4190
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
Enumeration date
08/07/2019
Last updated
08/07/2019
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