PURSUECARE CONNECTICUT PC

Provider Demographics

• NPI: 1003443185
• Name: PURSUECARE CONNECTICUT PC
• Entity Type: Organization
• Organization Name: PURSUECARE CONNECTICUT PC
• Authorized Official - Title/Position: AUTHORIZED
• Authorized Official - First Name: MELISSA
• Authorized Official - Last Name: KING
• Authorized Official - Phone: 860-322-6712
• Mailing Address - Street 1: 101 CENTERPOINT DR STE 105
• Mailing Address - City: MIDDLETOWN
• Mailing Address - State: CT
• Mailing Address - Zip Code: 06457-7568
• Mailing Address - Country: US
• Mailing Address - Phone: 860-317-5251
• Mailing Address - Fax: 860-469-2766
• Practice Address - Street 1: 101 CENTERPOINT DR STE 105
• Practice Address - City: MIDDLETOWN
• Practice Address - State: CT
• Practice Address - Zip Code: 06457-7568
• Practice Address - Country: US
• Practice Address - Phone: 860-317-5251
• Practice Address - Fax: 860-469-2766
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2020-03-26
• Last Update Date: 2023-07-18
• Deactivation Date: 2023-04-26
• Reactivation Date: 2023-05-16

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry	Group - Multi-Specialty
No	101YA0400X	Behavioral Health & Social Service Providers	Counselor	Addiction (Substance Use Disorder)	Group - Multi-Specialty
No	101YP2500X	Behavioral Health & Social Service Providers	Counselor	Professional	Group - Multi-Specialty
No	103TC0700X	Behavioral Health & Social Service Providers	Psychologist	Clinical	Group - Multi-Specialty
No	103TC1900X	Behavioral Health & Social Service Providers	Psychologist	Counseling	Group - Multi-Specialty
No	104100000X	Behavioral Health & Social Service Providers	Social Worker		Group - Multi-Specialty
No	1041C0700X	Behavioral Health & Social Service Providers	Social Worker	Clinical	Group - Multi-Specialty
No	106H00000X	Behavioral Health & Social Service Providers	Marriage & Family Therapist		Group - Multi-Specialty
No	2083A0300X	Allopathic & Osteopathic Physicians	Preventive Medicine	Addiction Medicine	Group - Multi-Specialty
No	261Q00000X	Ambulatory Health Care Facilities	Clinic/Center		Group - Multi-Specialty
No	261QM0850X	Ambulatory Health Care Facilities	Clinic/Center	Adult Mental Health	Group - Multi-Specialty
No	363AM0700X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Medical	Group - Multi-Specialty
No	363LA2200X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Adult Health	Group - Multi-Specialty
No	363LP0808X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Psychiatric/Mental Health	Group - Multi-Specialty
No	364SA2100X	Physician Assistants & Advanced Practice Nursing Providers	Clinical Nurse Specialist	Acute Care	Group - Multi-Specialty