Provider Demographics
NPI:1356484794
Name:REDDY, BHAGYALAKSHMI (MD)
Entity Type:Individual
Prefix:DR
First Name:BHAGYALAKSHMI
Middle Name:
Last Name:REDDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BHAGYA
Other - Middle Name:
Other - Last Name:REDDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:141 E MAIN ST FL 4
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:915 RIVER RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457
Practice Address - Country:US
Practice Address - Phone:203-889-0445
Practice Address - Fax:203-574-9006
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0426112084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT10450310 WATERBURYOtherBEACON HEALTH STRATEGIES
CT060669107OtherUBH-UNITED HEALTH CARE WELLMORE GRP/FACILITY
CT3495823 WELLMOREOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherUBH- OXFORD LIBERTY/FREEDOM WELLMORE GRP/FACILITY
CT060669107OtherANTHEM BCBS OF CT -WELLMORE GRP/FACILITY
CT390269 WELLMOREOtherMHN MANAGED HEALTH NETWORK
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CT9413737 WELLMOREOtherAETNA BEHAVIORAL HEALTH
CT11726136OtherCAQH
CTAPBN-56223OtherAMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY-PSYCHIATRY
CTAPBN6957OtherAMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY -CHILD AND ADOLESCENT PSYCHIATRY
CT008037443Medicaid
CT060669107OtherOPTUM BEHAVIORAL HEALTH- UBH WELLMORE GRP/FACILITY
CT060669107OtherUBH-CONNECTICARE WELLMORE GRP/FACILITY
CT390269 INACTIVEOtherMHN TRICARE NORTH
CTCSP.0042193OtherCONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
CTCSP.0042193OtherCONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
CTAPBN-56223OtherAMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY-PSYCHIATRY