Healthcare Provider Details

I. General information

NPI: 1821956822
Provider Name (Legal Business Name): ABENA SOMUAH PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 FERGUSON RD
MANCHESTER CT
06040-4536
US

IV. Provider business mailing address

281 FERGUSON RD
MANCHESTER CT
06040-4536
US

V. Phone/Fax

Practice location:
  • Phone: 860-840-6635
  • Fax:
Mailing address:
  • Phone: 860-840-6635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number2025090062
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: