OrganizationActive
Centered PLLC
NPI 1699406132 · Psychiatric/Mental Health Clinical Nurse Specialist · New Haven, CT
Provider details
- NPI number
- 1699406132
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Brittainy Wagner, Billing Specialist(903) 213-1005
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Neurology Physician2084N0400X
Allopathic & Osteopathic Physicians
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Practice location
285 Nicoll St Ste 104
New Haven, CT 06511-2625
Phone: (203) 606-2395
Fax: (203) 643-2499
Approximate (ZIP-level) locationGet directions
Mailing address
285 Nicoll St
New Haven, CT 06511-2625
Additional practice locations (1)
- 290 Lexington AveNew Haven, CT 06513-4046Phone: (203) 606-2395Fax: (203) 643-2499
Registry dates
- Enumerated
- 2022-06-23
- Last updated
- 2025-01-28
- Certified
- 2025-01-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.